SFEBES2025 Oral Communications Neuroendocrinology and Pituitary (6 abstracts)
Venous thromboembolism risk in cushing’s disease, acromegaly and non-functioning pituitary adenomas: insights from three UK tertiary centres
Kristina Isand 1,2 , Riccardo Pofi 3 , Oliver Haermson 2 , Melissa Vergis 4 , Harishanthi Mahendran 4 , John Wass 2 , Parag Yajnik 5 , Karin Bradley 5 , Niki Karavitaki 4,6,7 & Aparna Pal 2
1University of Tartu, Tartu, Estonia; 2Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, United Kingdom; 3Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, United Kingdom; 4Department of Metabolism and Systems Research, College of Medicine and Health, University of Birmingham, Birmingham, United Kingdom; 5University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom; 6Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom; 76Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Objective: To assess risk of venous thromboembolism (VTE) in patients with Cushing’s disease (CD) compared to GH-secreting and non-functioning pituitary adenomas (NFAs). Timing and risk factors for VTE were recorded, with a detailed focus on VTEs in CD patients.
Design: A Retrospective, observational cohort study.
Methods: Patients diagnosed with acromegaly, NFA, or CD across three UK centres (OUH, QEHB, UHBW) between 2010 and 2021 were included. Chi-square, Kaplan-Meier survival, and Cox regression were performed to compare VTE cumulative probability and identify predictors. For the Cox regression, the period of study began four years prior to the diagnosis of pituitary tumour to capture VTEs prior to adenoma diagnosis.
Results: Among 827 patients (107 CD, 502 NFA, 218 acromegaly) followed for median 7±3 years, VTE rates were 11.2% in CD, 0.4% in NFA, 2.7% in acromegaly. Patients with CD had higher VTE risk compared to NFA (OR 21.05, 95% CI 5.83 to 76.02, P < 0.001) or acromegaly (OR 4.48, 95% CI 1.63 to 12.30, P = 0.002). Kaplan-Meier analysis showed shorter time-to-event in CD (p<0.001). Cox regression identified CD diagnosis (HR = 35.40; 95% CI 7.75 to 161.71; P < 0.001) and diabetes mellitus (HR 3.84; 95% CI 1.51 to 9.76; P = 0.005) as predictors of VTE. Eight/12 VTEs were diagnosed within one year pre- or post-diagnosis of CD. Four VTEs occurred shortly after transsphenoidal adenectomy (1-, 24-, 33-, and 35-days post-surgery). In contrast, VTEs in NFA and acromegaly patients occurred over a broader time interval (from four years before to twenty years post-diagnosis).
Conclusion: This study re-emphasises the increased risk of VTE CD patients specifically when comparing to patients with acromegaly or NFA. VTEs in patients with CD presented even one year following the diagnosis of hypercortisolaemia suggesting consideration should be given to what is the optimal duration of prophylaxis.
Volume 109
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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