Endocrine Abstracts

Pasireotide (Pas) is a multireceptor-targeted somatostatin analogue approved for the treatment of patients with Cushing’s Disease (CD) who fail or are poor candidates to surgery. Pas markedly improves signs and symptoms of the disease, reduces urinary free cortisol (UFC) up to its normalization in 55% of patients and pituitary tumour size in up to 100%. Here we present a patient with severe recurrent CD treated with Pas and showing opposite results between hormonal levels...

Steroids are still widely prescribed in pituitary trans-sphenoidal surgery (TSA). Pituitary-adrenal/thyroid/gonadal functions were prospectively evaluated in 72 consecutive NFPA pts (20–87 years, 37 M) before and after endoscopic-TSA (E-TSA) (63 at first operation, 9 at re-operation). All had macroadenoma with suprasellar extension: impinging optic chiasma in 28, extending into cavernous sinus (CS) in 23, giant in 12. Hydrocortisone was infused peri-operatively only in pt...

Patients: Nineteen acromegalic patients (8 females, 21-69 years-old, with macroadenoma, microadenoma or no evidence of pituitary tumor in 15, 2, 2, respectively) resistant to first generation somatostatin analogs (FG-SA) at high doses and/or intolerant to pegvisomant were switched to pasireotide LAR (PasLAR). Eleven had persistent disease after neurosurgery and two had also undergone radiosurgery (12 and 24 months before starting PasLAR). Six complained of acromegalic headache...

Background: Pasireotide is a multi-ligand somatostatin analogue licensed in a long-acting release formulation (PAS-LAR) for the treatment of acromegaly. The real-life reports with PAS-LAR are still scanty.Objectives: To assess the efficacy and safety of PAS-LAR in patients with acromegaly.Patients and methods: Prospective observational multi-centre study enrolling acromegalics evaluated before (baseline) and 1, 6, 12, 24, and 36 mo...

COVID-19 pandemic obliged physicians to find out alternative options to classical pathways, to lower viral spread and related dangers as well as to cope with redeployment of personnel and resources. We describe here two cases in whom surgery for adrenal Cushing’s syndrome (CS) and pheochromocytoma (PHEO) was deferred due to the unavailability of surgical facilities.Case no 1: A 69-yo woman was evaluated for CS. Type 2 diabetes mellitus was diagnosed...

The effects of conventional somatostatin analog (SSA) regimens on glucose homeostasis seem to have minor clinical impact in acromegaly. Recently, we performed a trial showing that high dose octreotide LAR significantly reduces IGF1 in acromegalic patients uncontrolled with conventional SSA doses. In this post-hoc analysis, we evaluated the effects of high doses versus high frequency octreotide LAR on glucose homeostasis (HbA1c, FPG, HOMA-R) in patients with acromegaly e...

Objective: In acromegaly, 25–50% of patients remain uncontrolled with conventional somatostatin analogue (SA) therapy. Evidence suggests that response may be improved by increasing the dose or frequency of administration of SAs. This study evaluated the efficacy and safety of octreotide LAR administered at a high dose or high frequency in patients with acromegaly.Methods: This was a 24-week prospective, multicenter, randomized, open-label trial in p...

Introduction: While searching for mechanisms contributing to the increased mortality of acromegaly, we have previously described an unexpected sympathoinhibition in newly diagnosed patients (Seravalle et al., Clin Endocrinol 77:262, 2012) and interpreted this finding as an adaptive phenomenon. It has also been shown that centrally administered somatostatin (SS) inhibits peripheral sympathetic outflow in rodents (Rettig et al., Am J Physiol 257:R588, 1989). Ba...

Methods: We undertook an assessment of patients which were diagnosed with or had their first symptoms of pituitary tumor before the age of 30 and had tumor diameter more than 1 cm without familial history of pituitary adenomas. In patients that consented to genetic analysis, germline mutations in the AIP gene were sought.Results: The study population consisted of 164 patients (61 prolactinomas, 84 somatotropinomas, 16 non-secreting tumors, two pat...

An increase in basal and Pentagastrin (Pg) stimulated calcitonin (CT) concentration is a specific feature of medullary thyroid carcinoma (MTC). Routine basal CT measurement in nodular thyroid diseases is controversial. Pg stimulation is expected to increase the basal CT specificity in MTC screening, although false positive responses in patients without MTC have been reported.Aim: To report the diagnostic accuracy of Pg-stimulated CT in surgically treated...