ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)
Adverse hepato-biliary-pancreatic events in acromegaly patients treated with first generation somatostatin analogues: an italian multicenter study
Francesco Ferraù 1 , Elena Sofia Blanca 2 , Marta Ragonese 1 , Angela Alibrandi 3 , Marianna Martino 4 , Giorgio Arnaldi 5 , Nunzia Prencipe 6 , Daniela Cuboni 6 , Silvia Grottoli 6 , Francesco Giorgino 7 , Anna Leonardini 7 , Giulia Carosi 8 , Giovanna Mantovani 9 & Salvatore Cannavò 1
1Endocrinology Unit, University Hospital “G. Martino”, Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy; 2Endocrinology Unit, University Hospital “G. Martino”, Messina, Italy; 3Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy; 4Division of Endocrinology, Marche University Hospital, Ancona, Italy; 5Endocrine, Metabolic and Nutritional Diseases, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University Hospital Policlinico "P. Giaccone", Palermo, Italy; 6Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy; 7Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy; 8Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; 9Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
JOINT3589
Introduction: First-generation somatostatin analogues (SSa) are first-line medical therapy for acromegaly. They are generally well-tolerated but during long-term therapy, cholelithiasis, which may require cholecystectomy (CH-Tx), and other hepato-biliary-pancreatic adverse events can occur. This study aimed at evaluating the prevalence of hepato-biliary/pancreatic adverse events during SSa treatment, and at identifying factors influencing their development.
Methods: 371 acromegaly patients (223F, age 63+0.77yrs) were evaluated retrospectively, collecting clinical/biochemical/instrumental data at diagnosis (T0), at SSa therapy start (T1) and at last follow-up visit (120+6.54 months). The occurrence of CH-Tx, cholecystitis (CH), mild hypertransaminasemia (<5xULN) or severe hypertransaminasemia (>5xULN) (HT), mild (<5xULN) or severe (>5xULN) hyperlipaemia/hyperamylasemia (HH) during SSa treatment, and their relationship with clinical and biochemical features at T0/T1 have been investigated.
Results: 61 patients (16.4%)(40F) underwent CH-Tx, 14 (3.8%) developed CH, 8 (2.2%) severe HH and 19 (5.12%) mild HH, 4 (1.1%) severe HT and 24 (6.47%) mild HT, without significant differences in terms of gender or after patients’ stratification by age >/< 50yrs. Chi-square test revealed that patients undergoing CH-TX or CH had a higher prevalence of biliary lithiasis at T1 (P = 0.002, P = 0.005, respectively), while mild hypertransaminasemia was associated with higher frequency of diabetes mellitus at T1 (P = 0.019). Cholecystectomy was associated to higher age and biliary sand at T1 (P = 0.018; P = 0.016, respectively), according to multivariate analysis, and with ursodeoxycholic acid (UDA) treatment at T1 in univariate analysis (P = 0.035). Cholecystitis was associated with UDA treatment (P = 0.003) and elevated GH-levels at T1 (P = 0.044) in univariate and multivariate analyses, respectively. Severe HH was associated with UDA treatment in both univariate (P = 0.003) and multivariate analyses (P = 0.026). The occurrence of mild or severe HT was associated, in univariate analysis, with UDA treatment (P = 0.056) and biliary lithiasis at T1 (P = 0.055), respectively. When considering hepato-biliary-pancreatic adverse events overall, they were found to be significantly associated to age, biliary lithiasis, and biliary sand at T1 in both univariate (P = 0.013, P = 0.006, P = 0.010, respectively) and multivariate analyses (P = 0.044, P = 0.029, P = 0.028, respectively).
ConclusionS: Hepato-biliary/pancreatic adverse events during long-term treatment with SSa are not infrequent, and overall influenced by age, cholelithiasis and biliary sand. The relevance of preexisting hepato-biliary issues in their occurrence is also demonstrated by the evidence of the association with UDA treatment.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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