ECE2013 Poster Presentations Pituitary – Clinical (<emphasis role="italic">Generously supported by IPSEN</emphasis>) (127 abstracts)
Efficacy and safety of lanreotide in combination with cabergoline in clinical practice in patients with active acromegaly with monotherapy failure
Ricardo Vilchez 1 , Ignacio Bernabeu 2 , Concepción Blanco 3 , Fernando Cordido 4 , Miguel Paja 5 , Rosa Casany 6 , Carmen Fajardo 7 , Silvia Maraver 8 , Tomás Martín 9 , Tomás Lucas 10 , Juan Antonio García Arnes 11 , Pablo Fernández Catalina 12 , María Purificación Martínez de Icaya 13 , Gemma Sesmilo 14 , Antonio Picó 15 , Mónica Marazuela 16 , Alfonso Soto 17 , Manuel Puig Domingo 18 & on behalf of ACROCOMB study group 19
1Hospital Universitario Virgen de las Nieves, Granada, Spain; 2Hospital Clínico Universitario, Santiago de Compostela, Spain; 3Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain; 4Hospital Universitario A Coruña, A Coruña, Spain; 5Hospital Universitario de Basurto, Bilbao, Spain; 6Hospital Llus Alcanyís, Xàtiva, Spain; 7Hospital Universitario La Ribera, Alcira, Spain; 8Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; 9Hospital Universitario Virgen Macarena, Sevilla, Spain; 10Hospital Universitario Puerta de Hierro, Majadahonda, Spain; 11Hospital Universitario Carlos Haya, Málaga, Spain; 12Hospital Universitario de Pontevedra, Pontevedra, Spain; 13Hospital Severo Ochoa, Leganés, Spain; 14Instituto Universitario USP Dexeus, Barcelona, Spain; 15Hospital General Universitario de Alicante, Alicante, Spain; 16Hospital Universitario La Princesa, Madrid, Spain; 17Hospital Universitario Virgen del Rocío, Sevilla, Spain; 18Hospital. Universitario Germans Trias i Pujol, Badalona, Spain; 19ACROCOMB study, Spain, Spain.
Introduction: ACROCOMB, a retrospective Spanish Multicenter study, evaluated the efficacy and safety of lanreotide (LAN) combined with cabergoline (CAB), or pegvisomant in patients with acromegaly.
Methods: patients treated with LAN+CAB at 44 Spanish Endocrinology Departments were included.
Results: 33% male patients, median age: 50.4 years. Mean time from diagnosis: 5.9±6.9 years. Tumour size at diagnosis: 21.9 mm. 83% of patients had undergone surgery and 38% had received radiotherapy. Medical treatment immediately prior to LAN+CAB, was LAN (57%), octreotide (10%), or dopamine agonist (15%). 70% of patients received LAN+CAB to improve their hormonal control; 17% had mixed tumours (PRL/GH) and LAN+CAB was their first medical treatment. Median LAN+CAB treatment duration was 1.5 years (0.1–6). Median LAN doses were 90 mg/month (60–120) at baseline (42% received <120 mg) and 120 mg/month (60–240) at end of study (EOS) although 22% received <120 mg. An extended LAN regimen (q6w or q8w) was administered to 13% of patients at baseline and 14% at EOS. Median CAB dose was 1 mg/week (0.25–5) at baseline and 1.4 mg/week (0.25–5) at EOS. Median GH and IGF1 values at baseline, 6 months and EOS were: GH, 4 ng/ml (0–400), 3 ng/ml (0–135), 2 ng/ml (0–103); IGF1, 144% ULN (15–505%), 115% ULN (13–557%), 105% ULN (13–557%) P<0.0001. At EOS, GH <2.5 ng/ml was reached in 51% of patients and normal age-adjusted IGF1 in 46%. Tumour size decreased in 8 patients. At EOS 48 (75%) patients were receiving LAN+CAB. Main reason for discontinuation was lack of efficacy (13%).
Conclusion: The LAN+CAB combination is frequently used and well-tolerated in clinical practice with efficacy similar to what has been reported in the literature, albeit a lower CAB dose, and appears to be clinically useful in some patients not controlled on monotherapy
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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