Endocrine Abstracts

In this workshop, we would like to discuss several clinical cases in the context of our recently published/collected data on bone health after childhood cancer therapy (below). Although risk factors for reduced BMD in childhood cancer survivors (CCS) had been identified, it remained unknown which survivors were at highest absolute risk of reduced BMD and might benefit from BMD assessment by DXA. In collaboration with the American SJLIFE cohort (n=2, 032), we developed...

Background: Efficacy and safety of combination treatment of pasireotide LAR with pegvisomant (PEGV) has not been studied yet. Switching to Pasireotide LAR in patients previously controlled with long-acting somatostatin analogues (LA-SSAs) and PEGV could reduce the required PEGV dose to normalize serum IGF1 levels, while the effect on glucose metabolism is unknown.Methods: We enrolled 60 acromegaly patients >18 years with acromegaly who had normal IGF...

Background: Acromegaly is a severe systemic condition characterized by elevated circulating levels of growth hormone (GH) and insulin-like growth factor I (IGF-I) and increased mortality and morbidity. The role of GH and IGF-I in mammary hyperplasia is well established and GH/IGF-I elevation has been hypothesized to favor neoplastic development. We recently demonstrated that premenopausal females with active acromegaly may display an increased mammographic breast density (MBD)...

Objective: Acromegaly is caused by a growth hormone (GH)-secreting pituitary tumor and its signs are linked to increasedGH-dependent hepatic insulin-like growth factor I (IGF-I) synthesis. A eucaloric very low-carbohydrate ketogenic diet (euVLCK; < 50 g/day) induces ketosis and reduces portal insulin concentrations, which down-regulate hepatic GH receptors and reduce IGF-I synthesis. Somatostatin receptor ligands (SRLs) reduce GH secretion by the pituitary tumor,resul...

Introduction: Pegvisomant (PEGV) has an efficacy of >90% to control insulin-like growth factor (IGF-1), however in everyday practice a limited efficacy of 63% was reported.Aim: To assess efficacy in the largest single center cohort of acromegalics using PEGV.Methods: A 112 subjects (65 male) were not controlled with high-dose somatostatin analogues (LA-SRIF) for at least 6 months. To control acromegaly, 109 subjects added PEGV ...

Introduction: Pegvisomant (PEGV) has an efficacy of >90% to control insulin-like growth factor-1. Main safety issues are elevated transaminases that seem to be related to Gilbert’s polymorphisms (GiPism) or gender and tumor-size increase (1).Aim: To assess safety in the largest single center cohort of acromegalics using PEGV.Methods: Results are expressed as median (interquartile-range).One-hundred a...

Objective: To assess if weekly administration of 40 mg pegvisomant (PEG-V) improves quality of life (QoL) and metabolic parameters in acromegalic patients with already normal age-adjusted insulin-like growth factor-I (IGF-I) concentrations during long-acting somatostatin analog (SSA) treatment.Design: Prospective investigator-initiated, double blind, placebo controlled, cross-over study. Twenty acromegalic subjects received for two consecutive treatment ...

Background: We previously reported on the efficacy, safety and Quality of Life of long-acting somatostatin analogs (SSA) and (twice) weekly pegvisomant (PEG-V) in acromegaly and improvement after the addition of PEG-V to long-acting SSA.Objective: To assess the long term safety in a larger group of acromegalic patients over a larger period of time; 29.2 (1.2–57.4) months (mean (range)).Design: Pegvisomant was added to SSA mono...

Background: In the core phase of the PAPE study until 24 weeks we have shown that switching to pasireotide LAR (PAS-LAR) in well-controlled acromegaly patients receiving combination therapy of somatostatin analogues and pegvisomant (PEGV), normalizes IGF1 levels in the majority of patients. PAS-LAR induced a significant PEGV sparing effect, but this was at the expense of a higher incidence of diabetes. This extension study until 48-weeks assesses the efficacy, safety and quali...

Background: Small functional pituitary adenomas can cause severely disabling symptoms and early death, however, surgical planning is often complicated due to inconclusive diagnostic MRI in up to 40% of patients and therefore hamper cure rates. We here introduce a novel method for the detection of small functional pituitary adenoma by O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET) PET-MRI.Methods: Patients with Cushing’s disease (CD) or acromegaly wit...