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Brazilian multicenter study on pegvisomant treatment in acromegaly
Boguszewski, Cesar L; Huayllas, Martha Katherine P; Vilar, Lucio; Naves, Luciana Ansaneli; Ribeiro-Oliveira Junior, Antonio; Soares, Beatriz Santana; Czepielewski, Mauro Antonio; Abucham, Julio; Correa-Silva, Silvia Regina; Bronstein, Marcello Delano; Jallad, Raquel Soares; Duarte, Felipe Gaia; Musolino, Nina Rosa; Kasuki, Leandro; Gadelha, Monica Roberto.
  • Boguszewski, Cesar L; Universidade Federal do Paraná. Hospital de Clínicas. Departamento de Medicina Interna. Curitiba. BR
  • Huayllas, Martha Katherine P; Hospital Brigadeiro. Departamento de Neuroendocrinologia. São Paulo. BR
  • Vilar, Lucio; Universidade Federal de Pernambuco. Hospital de Clínicas. Departamento de Endocrinologia. Recife. BR
  • Naves, Luciana Ansaneli; Universidade de Brasília. Faculdade de Ciências da Saúde. Brasília. BR
  • Ribeiro-Oliveira Junior, Antonio; Universidade Federal de Minas Gerais. Departamento de Endocrinologia. Laboratório de Endocrinologia. Belo Horizonte. BR
  • Soares, Beatriz Santana; Universidade Federal de Minas Gerais. Departamento de Endocrinologia. Laboratório de Endocrinologia. Belo Horizonte. BR
  • Czepielewski, Mauro Antonio; Universidade Federal do Rio Grande do Sul. Hospital de Clínicas. Porto Alegre. BR
  • Abucham, Julio; Universidade Federal de São Paulo. Escola Paulista de Medicina. São Paulo. BR
  • Correa-Silva, Silvia Regina; Universidade Federal de São Paulo. Escola Paulista de Medicina. São Paulo. BR
  • Bronstein, Marcello Delano; Universidade de São Paulo. Faculdade de Medicina. Hospital de Clínicas. São Paulo. BR
  • Jallad, Raquel Soares; Universidade de São Paulo. Faculdade de Medicina. Hospital de Clínicas. São Paulo. BR
  • Duarte, Felipe Gaia; Universidade de São Paulo. Faculdade de Medicina. Hospital de Clínicas. São Paulo. BR
  • Musolino, Nina Rosa; Universidade de São Paulo. Faculdade de Medicina. Hospital de Clínicas. São Paulo. BR
  • Kasuki, Leandro; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Centro de Pesquisa em Neuroendocrinologia. BR
  • Gadelha, Monica Roberto; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Centro de Pesquisa em Neuroendocrinologia. BR
Arch. endocrinol. metab. (Online) ; 63(4): 328-336, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019350
ABSTRACT
ABSTRACT Objective Investigate the therapeutic response of acromegaly patients to pegvisomant (PEGV) in a real-life, Brazilian multicenter study. Subjects and methods Characteristics of acromegaly patients treated with PEGV were reviewed at diagnosis, just before and during treatment. All patients with at least two IGF-I measurements on PEGV were included. Efficacy was defined as any normal IGF-I measurement during treatment. Safety data were reviewed. Predictors of response were determined by comparing controlled versus uncontrolled patients. Results 109 patients [61 women; median age at diagnosis 34 years; 95.3% macroadenomas] from 10 Brazilian centers were studied. Previous treatment included surgery (89%), radiotherapy (34%), somatostatin receptor ligands (99%), and cabergoline (67%). Before PEGV, median levels of GH, IGF-I and IGF-I % of upper limit of normal were 4.3 µg/L, 613 ng/mL, and 209%, respectively. Pre-diabetes/diabetes was present in 48.6% and tumor remnant in 71% of patients. Initial dose was 10 mg/day in all except 4 cases, maximum dose was 30 mg/day, and median exposure time was 30.5 months. PEGV was used as monotherapy in 11% of cases. Normal IGF-I levels was obtained in 74.1% of patients. Glycemic control improved in 56.6% of patients with pre-diabetes/diabetes. Exposure time, pre-treatment GH and IGF-I levels were predictors of response. Tumor enlargement occurred in 6.5% and elevation of liver enzymes in 9.2%. PEGV was discontinued in 6 patients and 3 deaths unrelated to the drug were reported. Conclusions In a real-life scenario, PEGV is a highly effective and safe treatment for acromegaly patients not controlled with other therapies.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Acromegaly / Receptors, Somatostatin / Human Growth Hormone / Cabergoline Type of study: Controlled clinical trial / Prognostic study Limits: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Brigadeiro/BR / Universidade Federal de Minas Gerais/BR / Universidade Federal de Pernambuco/BR / Universidade Federal de São Paulo/BR / Universidade Federal do Paraná/BR / Universidade Federal do Rio Grande do Sul/BR / Universidade Federal do Rio de Janeiro/BR / Universidade de Brasília/BR / Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Acromegaly / Receptors, Somatostatin / Human Growth Hormone / Cabergoline Type of study: Controlled clinical trial / Prognostic study Limits: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Brigadeiro/BR / Universidade Federal de Minas Gerais/BR / Universidade Federal de Pernambuco/BR / Universidade Federal de São Paulo/BR / Universidade Federal do Paraná/BR / Universidade Federal do Rio Grande do Sul/BR / Universidade Federal do Rio de Janeiro/BR / Universidade de Brasília/BR / Universidade de São Paulo/BR