ECE2022 Poster Presentations Adrenal and Cardiovascular Endocrinology (87 abstracts)
Long-term efficacy and safety of pasireotide in patients with Cushing’s disease: a monocentric experience
Ylenia Alessi 1 , Maria Luisa Torre 2 , Salvatore Giovinazzo 2 , Giuseppe Giuffrida 2 , Annalisa Giandalia 2 , Rosalinda Casablanca 1 , Filippo Flavio Angileri 3 , Marta Ragonese 2 , Francesco Ferraù 1,2 & Salvatore Cannavò 1,2
1Endocrine Unit, “Gaetano Martino” University Hospital of Messina, Italy; 2Department of Human Pathology of Childhood and Adulthood “Gaetano Barresi”, University of Messina, Italy; 3Department of Biomedical and Dental Sciences, and Morpho-Functional Imaging, University of Messina, Italy
Pasireotide is the first pituitary-directed approved therapy for Cushing’s disease (CD), effective in reducing UFC >50% in about half of patients, and with a good tolerability profile but associated with a relatively high incidence of hyperglicemia. The aim of this study was to evaluate efficacy and safety of long-term treatment with pasireotide (PAS) in patients with CD. Methods: We retrospectively evaluated 17 consecutive patients (11 females) with CD treated with PAS (with a mean follow of 40.4±12.5 months), referred to and followed-up at the Endocrine Unit of the University Hospital of Messina (Italy), from 2013 to 2020. Data are expressed as mean±SD. Age at diagnosis was 34.7±13.0 yrs. Before PAS treatment: all patients underwent transnasosphenoidal pituitary adenomectomy, but surgery was not successful in 10 cases, while disease recurred in the other seven; five patients underwent also radiotherapy; seven patients were administered other medical therapies. Anthropometric, clinical, hormonal and metabolic (glucidic and lipidic profile) parameters were evaluated, along with cardiometabolic CD-related comorbidities, before PAS treatment and at last follow-up visit. Side-effects and adverse events related to treatment were also evaluated.
Results: Before PAS treatment, 47% of patients were obese, 59% were dyslipidemic, 47% had diabetes, and 53% were on antihypertensive treatment. Under PAS treatment, 76% of patients achieved a normalization or ≥50% reduction of UFCxULN from baseline. At last follow-up visit as compared to baseline: body weight, BMI, waist-to-hip ratio, waist circumference, systolic and diastolic blood pressure decreased but were not significantly different (p NS); lipid profile significantly improved (total and LDL cholesterol, p 0.007 and p 0.001 respectively); glycated hemoglobin significantly increased (p 0.02). In terms of safety profile, most common adverse events were related to hyperglycemia and to difficult-to-manage diabetes mellitus (41%), which led to treatment withdrawal in 4 cases. No patient experienced QTc interval prolongation.
Conclusion: Pasireotide is a safe and effective treatment in a significant figure of patients with CD, improving also lipid profile, while frequently causing glucose metabolism alterations which represent a cause of therapy discontinuation.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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