Endocrine Abstracts

Acromegaly is a chronic disease caused almost invariably by a pituitary GH-secreting adenoma leading to overproduction of insulin-like growth factor I (IGF-I). The long-term hypersecretion leads to many comorbidities, as diabetes mellitus, arterial hypertension, and cardiovascular and/or pulmonary disease (including sleep apnea), which are related to an increased mortality rate. In fact, uncontrolled acromegaly is associated with a three times mortality rate as compared with n...

Background: The SAGIT® instrument, designed to assist clinicians in staging and managing acromegaly, is undergoing validation. A descriptive analysis of SAGIT Validation study baseline data revealed discrepancies between investigator-evaluated disease-control status, disease activity, hormonal control, and treatment decisions in acromegaly.Objective: To describe the baseline characteristics of patients in the SAGIT® valida...

Introduction: Around 20–30% of patients with acromegaly have hyperprolactinemia, which is associated with infertility and gonadal/sexual dysfunction. Current therapy involves somatostatin analogues for GH/IGF1 excess and a dopamine agonist to decrease prolactin levels. The objectives of this analysis were to assess treatment with pasireotide LAR or octreotide LAR alone in patients with acromegaly and hyperprolactinemia.Methods: Patients with acromeg...

Introduction: A monthly, long-acting formulation of pasireotide normalized or reduced mean urinary free cortisol (mUFC) in most patients with Cushing’s disease (CD) in a multicentre, double-blind, Phase III study. The effects of long-acting pasireotide on signs and symptoms of CD are reported here.Methods: Patients with persistent/recurrent (n=123) or de novo (non-surgical candidates; n=27) CD and mUFC≥1.5–5xULN...

Introduction: High affinity binding of pasireotide for both sst2 and sst5 leads to its enhanced efficacy in treatment of acromegaly but results in decreased secretion of insulin, incretins (GLP-1 and GIP) and, to a lesser extent, glucagon. Metformin may be a good option in patients with acromegaly experiencing hyperglycaemia with pasireotide as it improves GLP-1 secretion. We analysed data from a 12-month, Phase III, randomised study in medically naï...

Introduction: EDIs with LAN-ATG therapy may help improve the burden associated with long-term acromegaly management. The LEAD study evaluated the efficacy and safety of this approach by switching from OCT-LAR conventional dosing to LAN-ATG EDI.Methods: LEAD was a multinational, multicentre, open-label, non-comparative study. Acromegalic patients with normal IGF1 after OCT-LAR 10 or 20 mg injections every 4 weeks for ≧6 months were switched to LAN-...

Introduction: Pasireotide LAR was significantly superior to octreotide LAR at providing biochemical control in a 12-month trial in 358 medically naïve patients with acromegaly. Patients with clinical benefit or GH <2.5 μg/l and IGF1≤ULN could continue therapy in the extension study.Methods: Patients entering the extension (pasireotide LAR, n=74; octreotide LAR, n=46) were followed up to month 26 (core plus extension)...

Introduction: The PAOLA study in patients with inadequately-controlled acromegaly (n=198) demonstrated superior efficacy of pasireotide long-acting release (LAR; 40 mg/60 mg) in biochemical control (GH <2.5 μg/l and normalized IGF-1) vs continued treatment with octreotide LAR 30 mg/lanreotide Autogel 120 mg (15.4% and 20.0% vs 0%). Here we report preliminary data from the extension phase of PAOLA at wk28.Methods: Pasireotide-LAR (40 mg/...

Background: Some patients with acromegaly do not achieve biochemical control despite receiving maximum-approved doses of currently available somatostatin analogues. This 24-week, randomized study assessed the multireceptor-targeted somatostatin analogue pasireotide LAR vs octreotide LAR/lanreotide Autogel in patients with inadequately controlled acromegaly.Methods: Eligible patients: ≥18 years with mean GH levels ≥2.5 μg/l and IGF1 level...

Introduction: In a Phase III trial, pasireotide LAR was significantly superior (P=0.007) to octreotide LAR at providing biochemical control at 12 months in medically naïve acromegaly patients (post-pituitary surgery or de novo). Inadequately controlled patients (GH≥2.5 μg/l and/or IGF-1>ULN) at the end of core study were eligible for switching therapy (crossover extension). Reported here are efficacy results up to 12 months and safety resu...