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: A robust clinical programme of 14 trials demonstrated pasireotide as an effective treatment for patients with rare endocrine disorders, including acromegaly and Cushing’s disease (CD). Patients with acromegaly or CD have significant morbidity, reduced quality of life and, if inadequately treated, higher mortality risk than the general population. This 8-year interim analysis evaluated long-term safety of pasireotide treatment in patients with acromegaly, CD ...

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...