ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Natural history of non-functioning pituitary microadenomas: A systematic review and individual participant data meta-analysis
Victor Brun Boesen 1 , Tue Hansen 1,2 , Mohammad Motawea 1 , Roxana Damilano 3 , Maria Fleseriu 4 , Elena Varmalov 4 , Ashley Han 4,5 , Giovanna Mantovani 6,7 , Andrea Lania 8 , Giulia Carosi 6,7 , Nele Lenders 9 , Warrick Inder 10 , Syed Imran 11 , Le Min 12 & Jesper Krogh 1,2
1Clinic for Pituitary Disorders, Department of Medicine, Zealand University Hospital, Køge, Denmark; 2Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; 3Servicio de Endocrinología, Sanatorio Allende, Cordoba, Argentina; 4Pituitary Center, Department of Neurological Surgery and Department of Medicine, Oregon Health & Science University, Portland, United States; 5Mayo Clinic, Dept of Internal Medicine, Rochester, United States; 6Endocrinology Unit, Fondazione IRCCS Cà Granada Ospedale Maggiore Policlinico, Milan, Italy; 7Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; 8Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Italy; 9Department of Endocrinology, St Vincent’s Hospital, Sydney, Australia; 10Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia; 11Division of Endocrinology and Metabolism, Dalhousie University, Halifax, Canada; 12Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, United States
JOINT3603
Background: Increased neuroimaging for different indications and thus prevalence of non-functioning pituitary adenomas (NFPAs) is set to impose a significant burden on patients, practitioners, and amplify costs due to the need for complex and extensive follow-up.
Objective : To determine the risk of surgical intervention and the risk of developing a new endocrinopathy during follow-up in patients with conservatively treated micro-NFPAs.
Methods: We conducted a bibliographical search on PubMed and EMBASE identifying relevant studies. Authors of eligible studies were invited to share individual participant data (IPD). Eligible studies were cohort studies including patients with conservatively treated micro-NFPAs with at least one follow-up MRI. Fourteen studies met the inclusion criteria. Six authors provided IPD (n = 588). Data were reanalyzed for verification. In case of discrepancies the original authors were contacted for authentication. Data was extracted using a pre-piloted form.
Results: Risk estimates were reported as number of events per 100 person-years (PYs). Estimates were pooled using the two-step approach. Overall risk of surgery was 0.2/100PYs (95%CI: 0.0 to 0.5; I2=31%). Risk of surgery due to visual impairment was 0.1/100PYs (95%CI: -0.1 to 0.2; I2=0%). Risk of developing a new endocrinopathy was 1.3/100PYs (95%CI: 0.3 to 2.2; I2=47%). We found no difference in risk relative to baseline tumor size (≥6 mm or <6 mm), sex, or age (all P-values>0.25). Data for classical meta-analysis were available for 7 studies (n = 1079) and supported the IPD Results.
Conclusions: Events relevant to patients such as surgery or development of new endocrinopathies rarely occurs in patients with micro-NFPAs and routine follow-up can safely be reduced in the majority of these patients. Current guidelines may need to be revisited regarding this issue.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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