Endocrine Abstracts

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...

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...

Introduction: Cortistatin (CST) is a 17 amino-acid neuropeptide involved in sleep regulation. Due to its structural resemblance to somatostatin (SS), CST binds with high affinity to the 5 known SS receptors. CST also binds to the putative MrgX2 receptor. Previously we demonstrated that various types of human immune cells and tissues as well as lymphoid cell lines express CST mRNA. We suggested that CST plays a regulatory role in immune cell function both in physiological and p...

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: A common request at an endocrine outpatient clinic is to rule out acromegaly in a patient with acromegaloid features. It is important to do so, since the excessive excretion of growth hormone can result in various serious comorbidities. But when growth hormone-IGF-1 axis abnormalities are excluded, the physician faces a diagnostic dilemma. Here we provide a systematic approach to these patients.Methods: We present a case series of patients vi...

Introduction: Growth hormone (GH) is not only important for growth during childhood. Also, for (young) adults, growth hormone is important for bone mass, muscle strength and metabolism. GH deficiency (GHD) is a condition that can cause a broad range of adult health issues, if left untreated. Therefore on one hand, it is important to confirm and treat GHD after transfer to adult care. On the other hand, the personal and financial burden of unnecessary growth hormone in...

Objective: Growth hormone treatment (GHT) is a widely accepted treatment in growth hormone deficient (GHD) adults with nonfunctioning pituitary adenoma (NFPAs). However, concerns remain about the safety of GHT, because of its potentially stimulating effect on tumour (re)growth. The aim of this study was to evaluate tumour progression in NFPA patients using GHT.Patients and methods: From the Dutch National Registry of growth hormone treatment in adults, a...

Introduction: Adrenal insufficiency, or relative insufficiency, might partly explain increased mortality rates in nephroblastoma and neuroblastoma survivors after unilateral adrenalectomy. Aim of this study was to assess adrenal function and its metabolic effects after unilateral adrenalectomy.Patients and Methods: Cross-sectional study with a socio-demographically similar control group, conducted between October 2009-March 2011 at the Erasmus University...

Introduction: Daily administration of Pegvisomant normalizes IGF1 levels >71% of acromegalics (1). Few studies have assessed the efficacy of weekly administration. We assessed the efficacy of weekly pegvisomant for 12 months, after withdrawal of long-acting somatostatin analogs (SSA) in acromegalics previously controlled on combination therapy.Design: Fifteen subjects (8 males), age 58 (35–80) (median (range)) years on combination therapy of hig...

In Europe more than 50 million adults are diabetic. Of these, 90–95% have type 2 diabetes (T2D). It is also recognized that an even larger population is insulin resistant and it is thought that treatment at this early phase of the metabolic syndrome may prevent the occurrence of overt diabetes and associated pathologies. We are in the process of developing unacylated ghrelin (UAG) analogues as therapeutics for T2D. Towards this goal, we have used a mouse protocol in which...