ECE2018 Oral Communications The curious case of growth hormone (5 abstracts)
Effects of pegvisomant on glucose metabolism in acromegaly: A meta-analysis of prospective interventional studies
Tiziana Feola 1 , Alessia Cozzolino 1 , Giulia Puliani 1 , Emilia Sbardella 1 , Daniele Gianfrilli 1 , Valeria Hasenmajer 1 , Ilaria Simonelli 2 , Patrizio Pasqualetti 2 , Andrea Lenzi 1 & Andrea M. Isidori 1
1Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; 2Medical Statistics and Information Technology, AFaR, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy.
Introduction: Glucose metabolism impairment is a common complication of acromegaly. Pegvisomant (PEG) is used as second-line medical treatment in acromegaly. Data from literature suggest a positive effect of PEG on glucose metabolism but a meta-analysis has never been performed.
Aim: To address the following questions: i) does PEG affect glucose metabolism? ii) does the effect correlate with disease control?
Methods: We performed a meta-analysis of prospective interventional studies reporting the use of PEG for the treatment of acromegaly. We searched MEDLINE, EMBASE, and SCOPUS for English-language studies. Inclusion criteria: minimum 6-month follow-up, glyco-metabolic outcomes before and after PEG treatment. The pooled estimate of a weighted mean was obtained for all outcomes using a random effects model.
Results: Fifteen studies met inclusion criteria. PEG treatment induced a significant decrease in fasting plasma glucose (FPG) (effect size (ES) −0.90 mmol/l, 95%CI:−1.15–−0.66; P=0.000), HbA1c (ES −0.48%, 95%CI:−0.59–−0.37; P=0.000), fasting plasma insulin (FPI) (ES −5.12 mU/l, 95%CI:−8.99–−1.22; P=0.010) and HOMAi (ES −0.80, 95%CI:−1.38–−0.22; P=0.007), without changes of triglyceridemia, glucose load (2h-OGTT), HOMAβ, weight and BMI. Meta-regression was possible only for FPG and FPI and it revealed not significant effect of post-pre treatment IGF-1 mean difference on the pooled estimate.
Conclusions: PEG induces a significant decrease in FPG, HbA1c, FPI and HOMAi. These results suggest that PEG treatment improves glucose metabolism in acromegaly and this effect seems to be independent from disease control.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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