Brazilian multicenter study on pegvisomant treatment in acromegaly
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.
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
Similar
MEDLINE
...
LILACS
LIS