Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 37 EP88 | DOI: 10.1530/endoabs.37.EP88

ECE2015 Eposter Presentations Adrenal cortex (94 abstracts)

A single-centre 10-years experience with pasireotide in Cushing's disease: patients characteristics and outcome

Laura Trementino 1, , Grazia Michetti 1, , Alessia Angeletti 1, , Giorgia Marcelli 1, , Carolina Concettoni 1, , Marina Cardinaletti 1, , Barbara Polenta 1, , Marco Boscaro 1, & Giorgio Arnaldi 1,

1Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy; 2Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padua, Padua, Italy.

Introduction: Pasireotide is the first pituitary-directed drug approved for Cushing’s disease (CD). We report our 10-years experience with pasireotide in CD reviewing and analysing data about all the patients treated with pasireotide at our referral centre both in randomised trials and in clinical practice.

Patients and methods: Twenty active CD patients were treated. Fourteen patients were treated with pasireotide in randomised trials and six patients were treated with pasireotide s.c. (Signifor; Novartis AG) in clinical practice. The mean treatment duration was 20.5 months (median 9 months; range, 3–72 months). The mean daily s.c. dose was 1333 μg (range, 1200–1800 μg) at the beginning of treatment as well as 1366 μg at last follow-up (range, 600–2400 μg).

Results: Urinary free cortisol (UFC) levels mean percentage change (±S.D.) at last follow-up was –40.4% (±35.1; range, 2–92%; median reduction 33.3%) with a normalisation rate of 50% (10/20). UFC normalisation occurred by months 1–3 in the majority of patients (8/10; 80%). Ten patients achieved sustained normalised late night salivary cortisol (LNSC) levels during treatment. LNSC normalisation was associated with UFC normalization (7/10 patients). Serum cortisol and plasma ACTH significantly decreased from baseline to last follow-up. Body weight decrease and blood pressure improvement during treatment were independent from UFC response. Glucose profile worsening was observed in all the patients except one. The frequency of diabetes increased from 40% (8/20) at baseline to 85% (17/20) at last follow-up requiring to start medical treatment only in a half of patients (8/17).

Conclusions: Pasireotide treatment was associated with sustained biochemical and clinical benefit in about 50% of CD patients. Glucose profile alterations are a frequent complication of pasireotide treatment however this adverse event seems to be easy to manage with diet and lifestyle intervention in almost half of patients.

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