Pegvisomant in acromegaly: a multicenter real-life study in Argentina
Arch. endocrinol. metab. (Online)
;
63(4): 320-327, July-Aug. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1019363
ABSTRACT
ABSTRACT Objective To describe the long term safety and efficacy of pegvisomant (PEGV), and the predictors of treatment response in patients with acromegaly in the real life setting. Subjects and methods We retrospectively reviewed the clinical, hormonal and radiological data of acromegalic patients treated with PEGV in 17 Argentine centers. Results Seventy-five patients (age range 22-77, 51 females) with acromegaly have been treated with PEGV for up to 118 months (median 27 months). Before PEGV, 97.3% of patients had been treated with medical therapy, surgery and/or radiotherapy, two patients had no previous treatment. At that time, all patients had an IGF-1 above the upper normal limit (ULN) (mean 2.4 x ULN ± 0.98, range 1.25-7). At diagnosis of acromegaly 84% presented macroadenomas, prior to PEGV only 23,5% of patients remained with tumor remnant > 1 cm, the remaining showed normal or less than 1 cm images. Disease control (IGF-1 ≤ 1.2 x ULN) was achieved in 62.9% of patients with a mean dose of 11.8 mg/day. Thirty-four patients (45%) received PEGV monotherapy, while 41 (55%) received combined therapy with either somatostatin analogues and/or cabergoline. Adverse events related to PEGV were local injection site reaction in 5.3%, elevated liver enzymes in 9.3%, and tumor size growth in 9.8%. Pre-PEGV IGF-I level was the only predictor of treatment response 2.1 x ULN vs 2.8 x ULN in controlled and uncontrolled patients respectively (p < 0.001). Conclusion this long term experience indicates PEGV treatment was highly effective and safe in our series of Argentine patients with acromegaly refractory to standard therapies. Arch Endocrinol Metab. 2019;63(4)320-7
Full text:
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Index:
LILACS (Americas)
Main subject:
Acromegaly
/
Somatostatin
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Dopamine Agonists
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Human Growth Hormone
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Cabergoline
Type of study:
Observational study
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Prognostic study
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Risk factors
Limits:
Adult
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Aged
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Female
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Humans
/
Male
Country/Region as subject:
South America
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Argentina
Language:
English
Journal:
Arch. endocrinol. metab. (Online)
Journal subject:
Endocrinology
/
Metabolism
Year:
2019
Type:
Article
Affiliation country:
Argentina
Institution/Affiliation country:
Clínica Caraffa/AR
/
Hospital Carlos G Durand/AR
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Hospital Carlos G. Durand/AR
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Hospital Churruca/AR
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Hospital Interzonal San Juan Bautista/AR
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Hospital Italiano de La Plata/AR
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Hospital Italiano/AR
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Hospital Militar Central/AR
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Hospital Privado de la Comunidad/AR
/
Hospital Ramos Mejía/AR
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