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Endocrine Abstracts (2022) 81 P680 | DOI: 10.1530/endoabs.81.P680

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1Università “Federico II” di Napoli, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Naples, Italy; 2Unesco Chair for Health Education and Sustainable Development, “Federico II” University, Naples, Italy


Pasireotide is a second-line therapy for acromegaly, that allows to obtain disease control in patients previously uncontrolled. However, pasireotide-induced hyperglycemia is of major concern. Currently, few data concerning prolonged use of pasireotide are available. The current retrospective study aimed at investigating the efficacy and safety of long-term pasireotide therapy. Sixteen consecutive patients (5 males, 11 females, age 47 ± 11 years) undergoing pasireotide for a minimal period of 36 months, were considered for the current study. In these patients, hormonal (GH, IGF-I), biochemical (fasting glucose and HbA1c), and radiological parameters (tumour maximal diameter and volume) have been considered at baseline and at 6, 12, 36 months, and last follow-up (LFU), during pasireotide therapy. At baseline, GH levels were 4.56 ± 3.82 ng/ml, IGF-I levels were 1.74 ± 0.72 x ULN, resulting 13 patients (81.25%) uncontrolled. Diabetes mellitus (DM) was present in 7 (43.75%), and 4 patients (25%) showed an impaired fasting glucose (IFG). After 6 months of pasireotide, GH and IGF-I levels were significantly reduced compared to baseline (P=0.017 andP=0.001, respectively). At 12 months, all patients achieved disease control (P<0.0001), tumour maximal diameter and volume were significantly reduced (P=0.003 andP=0.019, respectively). Disease control was maintained at 36 months evaluation, being tumour volume significantly further reduced compared to 12 months (P=0.010). Twelve patients (75%) were treated with pasireotide for a longer period (range 42-66 months); all these patients were controlled with a stable size adenoma at LFU. At 6 months, an increase in dose was recorded in 4 patients (25%, P=0.046), no further dose variation have been required. Pasireotide starting dose was significantly inversely correlated to IGF-I at 36 months (r=-0.614, P=0.011). Fasting glucose (FG) significantly increased in the first year of pasireotide therapy, particularly in the first 6 months (P=0.005); without a consistent increase in HbA1c (P=0.303) and DM (P=0.285). FG at 6 months was significantly correlated to age (r=0.692, P=0.003), rather than pasireotide dose (r=0.417, P=0.108). After 6 months, 75% IFG patients developed DM. At 36 months, 80% euglycemic patients at baseline were diabetic, and 20% showed IFG. As consequence, a significant increase in DM (P=0.023), and in the number of antidiabetic drugs used (P=0.005) were observed. Pasireotide therapy is effective in determining disease control, and tumour shrinkage, even after a long period of treatment. Change in FG mainly occur in the first period, depending on age and glycemic status before pasireotide starting.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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