Brazilian multicenter study on pegvisomant treatment in acromegaly
Arch. endocrinol. metab. (Online)
;
63(4): 328-336, July-Aug. 2019. tab, graf
Artículo
en Inglés
| 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.
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Índice:
LILACS (Américas)
Asunto principal:
Acromegalia
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Receptores de Somatostatina
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Hormona de Crecimiento Humana
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Cabergolina
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio pronóstico
Límite:
Adolescente
/
Adulto
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Anciano
/
Aged80
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Niño
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Arch. endocrinol. metab. (Online)
Asunto de la revista:
Endocrinologia
/
Metabolismo
Año:
2019
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
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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