Endocrine Abstracts

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...

Clinical trials have demonstrated that pegvisomant therapy is highly efficacious, normalizing serum IGF-I levels in the majority of patients with acromegaly. Multiple factors could influence the dose of pegvisomant required to normalize IGF-I, that ranging from 10 to 40 mg/day. However, the determinants of this variability are unknown and, to date, there is no specific recommendation to adjust the dose to the type of patient. Lack of exon 3 of the Growth Hormone receptor (d3-G...

Dopamine (DA) therapy of non-functioning pituitary adenomas (NFA) can result in tumor stabilization and shrinkage. However, this effect is not always apparent and the mechanism of action is still unknown. Previous evidence showed that DA inhibits pituitary Vascular Endothelial Growth Factor expression (VEGF), that, in turn, is related to pituitary tumor growth. Our study aimed at clarifying whether VEGF secretion modulation might mediate the effects of DA agonists and chimeric...

Myelolipomas are rare benign tumours resulting from myeloid and adipose mature cells proliferation, both elements have a clonal origin from a common precursor. Myelolipomas predominantly involve the adrenal gland but may develop in extra-adrenal sites. They are hormonally inactive but may coexist with active diseases such as adrenogenital syndrome. They are often asymptomatic but rarely they cause symptoms due to their size or spontaneous retroperitoneal haemorrhage. The myelo...

Previously, we demonstrated an inverse correlation between CoenzymeQ10 (CoQ10) and thyroid hormones, suggesting its usefulness as index of thyroid hormone tissue effect. A low-T3 syndrome, observed in chronic diseases, is considered an adaptive mechanism and its treatment is still debated. To evaluate the metabolic status of these patients and antioxidant vs energetic role of CoQ10, we studied 32 patients, with chronic obstructive pulmonary disease (COPD), comparing respirator...

Purpose: Primary hypophysitis is a rare disease, with an autoimmune etiology. As few papers have investigated its genetic, our aim was to evaluate HLA status in a single-center series of patients.Patients and method: A retrospective, longitudinal and cross-sectional study was conducted. Consecutive Caucasian patients, with clinical or histological diagnosis of primary autoimmune hypophysitis (PAH), undergone determination of HLA genotype, anti-pituitary ...

Introduction: Pasireotide Lar is a new generation long-acting somatostatin multireceptor ligand, approved for the treatment of first line somatostatin analogue resistant patients. We aimed to review Pasireotide Lar efficacy data, in our series of patients affected by aggressive acromegaly.Patients: A retrospective longitudinal study was conducted on patients with aggressive acromegaly, resistant to first-line somatostatin analogues (SSA) and on treatment...

Background: Acromegaly is associated with skeletal fragility and increased prevalence of vertebral fractures (VF). In recent years several authors tried to investigate predictor markers of bone fragility risk in this endocrine disorder. Two isoforms of GH receptor (GHR) have been described, which differ in the presence or absence of a transcript of exon 3 of the GHR gene. Both isoforms produce a functional receptor, but the exon 3-deleted isoforms (d3-GHR) have greater sensiti...

Introduction: Skeletal fragility is a relevant and not-reversible complication of acromegaly, involving around 30-40% of patients since the disease diagnosis. Few studies have investigated the effects on skeletal health of medical therapies for acromegaly. We aim to investigate the frequency of incident vertebral fractures (i-VFs) in patients treated with Pasireotide Lar + Pegvisomant (study group), after at least 24 consecutive treatment months and to compare the i-VFs freque...