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6. Évaluation de l’effet du dupilumab sur l’inflammation de type 2 des voies respiratoires et le bouchon de mucus chez les patients souffrant d’asthme modéré à sévère non contrôlé : l’essai VESTIGE

Author

Castro, M., primary, Papi, A., additional, Porsbjerg, C., additional, Lugogo, N.L., additional, Brightling, C.E., additional, González-Barcala, F.J., additional, Bourdin, A., additional, Ostrovskyy, M., additional, Staevska, M., additional, Chou, P.C., additional, Duca, L., additional, Pereira, A.M., additional, Fogarty, C., additional, Nadama, R., additional, Zhang, M., additional, Rodrigues, A., additional, Soler, X., additional, Pantelimon, S., additional, Sacks, H., additional, Deniz, Y., additional, Rowe, P.J., additional, De Prado Gómez, L., additional, and Jacob-Nara, J.A., additional

Published
2024
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13. Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Author

Bousquet, J., Hellings, P.W., Aberer, W., Agache, I., Akdis, C.A., Akdis, M., Alberti, M.R., Almeida, R., Amat, F., Angles, R., Annesi-Maesano, I., Ansotegui, I.J., Anto, J.M., Arnavielle, S., Asayag, E., Asarnoj, A., Arshad, H., Avolio, F., Bacci, E., Bachert, C., Baiardini, I., Barbara, C., Barbagallo, M., Baroni, I., Barreto, B.A., Basagana, X., Bateman, E.D., Bedolla-Barajas, M., Bedbrook, A., Bewick, M., Beghé, B., Bel, E.H., Bergmann, K.C., Bennoor, K.S., Benson, M., Bertorello, L., Białoszewski, A.Z., Bieber, T., Bialek, S., Bindslev-Jensen, C., Bjermer, L., Blain, H., Blasi, F., Blua, A., Bochenska Marciniak, M., Bogus-Buczynska, I., Boner, A.L., Bonini, M., Bonini, S., Bosnic-Anticevich, C.S., Bosse, I., Bouchard, J., Boulet, L.P., Bourret, R., Bousquet, P.J., Braido, F., Briedis, V., Brightling, C.E., Brozek, J., Bucca, C., Buhl, R., Buonaiuto, R., Panaitescu, C., Burguete Cabañas, M.T., Burte, E., Bush, A., Caballero-Fonseca, F., Caillot, D., Caimmi, D., Calderon, M.A., Camargos, P.A.M., Camuzat, T., Canfora, G., Canonica, G.W., Cardona, V., Carlsen, K.H., Carreiro-Martins, P., Carriazo, A.M., Carr, W., Cartier, C., Casale, T., Castellano, G., Cecchi, L., Cepeda Sarabia, A.M., Chavannes, N.H., Chen, Y., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A.G., Chung, K.F., Ciaravolo, M.M., Ciceran, A., Cingi, C., Ciprandi, G., Carvalho Coehlo, A.C., Colas, L., Colgan, E., Coll, J., Conforti, D., Correia de Sousa, J., Cortés-Grimaldo, R.M., Corti, F., Costa, E., Costa-Dominguez, M.C., Courbis, A.L., Cox, L., Crescenzo, M., Cruz, A.A., Custovic, A., Czarlewski, W., Dahlen, S.E., Dario, C., da Silva, J., Dauvilliers, Y., Darsow, U., De Blay, F., De Carlo, G., Dedeu, T., de Fátima Emerson, M., De Feo, G., De Vries, G., De Martino, B., de Paula Motta Rubini, N., Deleanu, D., Demoly, P., Denburg, J.A., Devillier, P., Di Capua Ercolano, S., Di Carluccio, N., Didier, A., Dokic, D., Dominguez-Silva, M.G., Douagui, H., Dray, G., Dubakiene, R., Durham, S.R., Du Toit, G., Dykewicz, M.S., El-Gamal, Y., Eklund, P., Eller, E., Emuzyte, R., Farrell, J., Farsi, A., Ferreira de Mello, J., Jr., Ferrero, J., Fink-Wagner, A., Fiocchi, A., Fokkens, W.J., Fonseca, J.A., Fontaine, J.F., Forti, S., Fuentes-Perez, J.M., Gálvez-Romero, J.L., Gamkrelidze, A., Garcia-Aymerich, J., García-Cobas, C.Y., Garcia-Cruz, M.H., Gemicioğlu, B., Genova, S., George, C., Gereda, J.E., Gerth van Wijk, R., Gomez, R.M., Gómez-Vera, J., González Diaz, S., Gotua, M., Grisle, I., Guidacci, M., Guldemond, N.A., Gutter, Z., Guzmán, M.A., Haahtela, T., Hajjam, J., Hernández, L., Hourihane, J.O.'B., Huerta-Villalobos, Y.R., Humbert, M., Iaccarino, G., Illario, M., Ivancevich, J.C., Jares, E.J., Jassem, E., Johnston, S.L., Joos, G., Jung, K.S., Jutel, M., Kaidashev, I., Kalayci, O., Kalyoncu, A.F., Karjalainen, J., Kardas, P., Keil, T., Keith, P.K., Khaitov, M., Khaltaev, N., Kleine-Tebbe, J., Klimek, L., Kowalski, M.L., Kuitunen, M., Kull, I., Kuna, P., Kupczyk, M., Kvedariene, V., Krzych-Fałta, E., Lacwik, P., Larenas-Linnemann, D., Laune, D., Lauri, D., Lavrut, J., Le, L.T.T., Lessa, M., Levato, G., Li, J., Lieberman, P., Lipiec, A., Lipworth, B., Lodrup Carlsen, K.C., Louis, R., Lourenço, O., Luna-Pech, J.A., Maciej, K., Magnan, A., Mahboub, B., Maier, D., Mair, A., Majer, I., Malva, J., Mandajieva, E., Manning, P., De Manuel Keenoy, E., Marshall, G.D., Masjedi, M.R., Maspero, J.F., Mathieu-Dupas, E., Matta Campos, J.J., Matos, A.L., Maurer, M., Mavale-Manuel, S., Mayora, O., Medina-Avalos, M.A., Melén, E., Melo-Gomes, E., Meltzer, E.O., Menditto, E., Mercier, J., Miculinic, N., Mihaltan, F., Milenkovic, B., Moda, G., Mogica-Martinez, M.D., Mohammad, Y., Momas, I., Montefort, S., Monti, R., Mora Bogado, D., Morais-Almeida, M., Morato-Castro, F.F., Mösges, R., Mota-Pinto, A., Moura Santo, P., Mullol, J., Münter, L., Muraro, A., Murray, R., Naclerio, R., Nadif, R., Nalin, M., Napoli, L., Namazova-Baranova, L., Neffen, H., Niedeberger, V., Nekam, K., Neou, A., Nieto, A., Nogueira-Silva, L., Nogues, M., Novellino, E., Nyembue, T.D., O'Hehir, R.E., Odzhakova, C., Ohta, K., Okamoto, Y., Okubo, K., Onorato, G.L., Ortega Cisneros, M., Ouedraogo, S., Pali-Schöll, I., Palkonen, S., Panzner, P., Papadopoulos, N.G., Park, H.S., Papi, A., Passalacqua, G., Paulino, E., Pawankar, R., Pedersen, S., Pépin, J.L., Pereira, A.M., Persico, M., Pfaar, O., Phillips, J., Picard, R., Pigearias, B., Pin, I., Pitsios, C., Plavec, D., Pohl, W., Popov, T.A., Portejoie, F., Potter, P., Pozzi, A.C., Price, D., Prokopakis, E.P., Puy, R., Pugin, B., Pulido Ross, R.E., Przemecka, M., Rabe, K.F., Raciborski, F., Rajabian-Soderlund, R., Reitsma, S., Ribeirinho, I., Rimmer, J., Rivero-Yeverino, D., Rizzo, J.A., Rizzo, M.C., Robalo-Cordeiro, C., Rodenas, F., Rodo, X., Rodriguez Gonzalez, M., Rodriguez-Mañas, L., Rolland, C., Rodrigues Valle, S., Roman Rodriguez, M., Romano, A., Rodriguez-Zagal, E., Rolla, G., Roller-Wirnsberger, R.E., Romano, M., Rosado-Pinto, J., Rosario, N., Rottem, M., Ryan, D., Sagara, H., Salimäki, J., Samolinski, B., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G.K., Schunemann, H.J., Scichilone, N., Schmid-Grendelmeier, P., Serpa, F.S., Shamai, S., Sheikh, A., Sierra, M., Simons, F.E.R., Siroux, V., Sisul, J.C., Skrindo, I., Solé, D., Somekh, D., Sondermann, M., Sooronbaev, T., Sova, M., Sorensen, M., Sorlini, M., Spranger, O., Stellato, C., Stelmach, R., Stukas, R., Sunyer, J., Strozek, J., Szylling, A., Tebyriçá, J.N., Thibaudon, M., To, T., Todo-Bom, A., Tomazic, P.V., Toppila-Salmi, S., Trama, U., Triggiani, M., Suppli Ulrik, C., Urrutia-Pereira, M., Valenta, R., Valero, A., Valiulis, A., Valovirta, E., van Eerd, M., van Ganse, E., van Hague, M., Vandenplas, O., Ventura, M.T., Vezzani, G., Vasankari, T., Vatrella, A., Verissimo, M.T., Viart, F., Viegi, M., Vicheva, D., Vontetsianos, T., Wagenmann, M., Walker, S., Wallace, D., Wang, D.Y., Waserman, S., Werfel, T., Westman, M., Wickman, M., Williams, D.M., Williams, S., Wilson, N., Wright, J., Wroczynski, P., Yakovliev, P., Yawn, B.P., Yiallouros, P.K., Yorgancioglu, A., Yusuf, O.M., Zar, H.J., Zhang, L., Zhong, N., Zernotti, M.E., Zidarn, M., Zuberbier, T., Zubrinich, C., Zurkuhlen, A., Bousquet, Jean, Hellings, Peter W., Agache, Ioana, Amat, Flore, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Anto, Josep M., Bachert, Claus, Bateman, Eric D., Bedbrook, Anna, Bennoor, Kazi, Bewick, Mickael, Bindslev-Jensen, Carsten, Bosnic-Anticevich, Sinthia, Bosse, Isabelle, Brozek, Jan, Brussino, Luisa, Canonica, Giorgio W., Cardona, Victoria, Casale, Thomas, Cepeda Sarabia, Alfonso M., Chavannes, Niels H., Cecchi, Lorenzo, Correia de Sousa, Jaime, Costa, Elisio, Cruz, Alvaro A., Czarlewski, Wienczyslawa, De Carlo, Giuseppe, De Feo, Giulia, Demoly, Pascal, Devillier, Philippe, Dykewicz, Mark S., El-Gamal, Yehia, Eller, Esben E., Fonseca, Joao A., Fontaine, Jean-François, Fokkens, Wytske J., Guzmán, Maria-Antonieta, Haahtela, Tari, Illario, Maddalena, Ivancevich, Juan-Carlos, Just, Jocelyne, Kaidashev, Igor, Khaitov, Musa, Kalayci, Omer, Keil, Thomas, Klimek, Ludger, Kowalski, Marek L., Kuna, Piotr, Kvedariene, Violeta, Larenas-Linnemann, Desiree, Laune, Daniel, Le, Lan T.T., Carlsen, Karin Lodrup, Lourenço, Olga, Mahboub, Bassam, Mair, Alpana, Menditto, Enrica, Milenkovic, Branislava, Morais-Almeida, Mario, Mösges, Ralph, Mullol, Joaquim, Murray, Ruth, Naclerio, Robert, Namazova-Baranova, Leyla, Novellino, Ettore, O'Hehir, Robyn E., Ohta, Ken, Okamoto, Yoshitaka, Okubo, Kimi, Onorato, Gabrielle L., Palkonen, Susanna, Panzner, Petr, Papadopoulos, Nikos G., Park, Hae-Sim, Paulino, Ema, Pawankar, Ruby, Pfaar, Oliver, Plavec, Davor, Popov, Ted A., Potter, Paul, Prokopakis, Emmanuel P., Rottem, Menachem, Ryan, Dermot, Salimäki, Johanna, Samolinski, Boleslaw, Sanchez-Borges, Mario, Schunemann, Holger J., Sheikh, Aziz, Sisul, Juan-Carlos, Rajabian-Söderlund, Rojin, Sooronbaev, Talant, Stellato, Cristiana, To, Teresa, Todo-Bom, Ana-Maria, Tomazic, Peter-Valentin, Toppila-Salmi, Sanna, Valero, Antonio, Valiulis, Arunas, Valovirta, Erkka, Ventura, Maria-Teresa, Wagenmann, Martin, Wang, De Yun, Wallace, Dana, Waserman, Susan, Wickman, Magnus, Yorgancioglu, Arzu, Zhang, Luo, Zhong, Nanshan, Zidarn, Mihaela, and Zuberbier, Torsten

Published
2019
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16. Geolocation with respect to personal privacy for the Allergy Diary app - a MASK study

Author

Samreth, D., Arnavielhe, S., Ingenrieth, F., Bedbrook, A., Onorato, G.L., Murray, R., Almeida, R., Mizani, M.A., Fonseca, J., Costa, E., Malva, J., Morais-Almeida, M., Pereira, A.M., Todo-Bom, A., Menditto, E., Stellato, C., Ventura, M.T., Larenas-Linnemann, D., Fuentes-Pérez, J-M., Huerta-Villalobos, Y.R., Cruz, A.A., Stelmach, R., da Silva, J., Emuzyte, R., Kvedariene, V., Valiulis, A., Annesi-Maesano, I., Bosse, I., Demoly, P., Devillier, P., Fontaine, J.F., Kuna, P., Samolinski, B., Klimek, L., Mösges, R., Pfaar, O., Shamai, S., Bewick, M., Ryan, D., Sheikh, A., Anto, J.M., Cardona, V., Mullol, J., Valero, A., Chavannes, N.H., Fokkens, W.J., Reitsma, S., Roller-Wirnsberger, R.E., Tomazic, P.V., Haahtela, T., Toppila-Salmi, S., Valovirta, E., Makris, M., Papadopoulos, N.G., Prokopakis, E.P., Psarros, F., Gemicioğlu, B., Yorgancioglu, A., Bindslev-Jensen, C., Eller, E., Kull, I., Wickman, M., Bachert, C., Hellings, P.W., Pugin, B., Bosnic-Anticevich, S., O’Hehir, R.E., Kolek, V., Sova, M., Wehner, K., De Vries, G., van Eerd, M., Laune, D., Wittmann, J., Bousquet, J., and Poncelet, P., the MASK study group

Published
2018
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32. Towards a pituitary apoplexy classification based on clinical presentation and patient journey

Author

Guijt, M.C., Najafabadi, A.H.Z., Notting, I.C., Pereira, A.M., Verstegen, M.J.T., Biermasz, N.R., Furth, W.R. van, Claessen, K.M.J.A., Endocrinology, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Endocrinology, Pituitary apoplexy, Spectrum of disease, Sub-acute and non-acute, Endocrinology, Diabetes and Metabolism, Acute, Classification system
Abstract

Purpose The condition of pituitary apoplexia contains the clinical spectre from life-threatening emergency to asymptomatic self-limiting course, which partly determines diagnostic delay and management. Outcome evaluation of course and management of pituitary apoplexia is hampered by the diverse presentation of this condition and requires appraisal. This study aimed to describe the patient journey, clinical presentation, and management of various types of pituitary apoplexy in a new classification to facilitate future outcome evaluation and identify unmet needs in the care process. Methods A single-center retrospective patient chart study was conducted between 2005–2021 (N = 98). Outcome measures were clinical symptoms at first presentation in hospital, being headache, consciousness, visual acuity, visual field defects (VFD), ophthalmoplegia, nausea, vomiting, fever, and hypopituitarism and care process characteristics. Results Mean age was 47.6 ± 16.6 years (51.0% male). We describe their patient journey and identified three different types, differing in clinical presentation, in-hospital route, and final treatment, e.g., Acute (type A, 52%), Subacute (type B, 22.5%), and Non-acute (type C, 25.5%). Type A generally presents with acute onset headaches, VFD, or ophthalmoplegia emergency setting, with lowest mean visual acuity of both eyes and frequent hypocortisolism. Conclusions Pituitary apoplexy can be approached as a spectrum of disease with 3 main subtypes, with a different initial presentation, different in-hospital route resulting in different management. Acknowledging subtypes with particular needs for (emergency) referrals to Pituitary Tumors Center of Excellence (PTCOE) will serve patient care improvements, outcome evaluations and address areas for improvement.

Published
2022

38. Peripheral glucocorticoid receptor antagonism by relacorilant with modest HPA axis disinhibition

Author

Viho, E.M.G., Kroon, J., Feelders, R.A., Houtman, R., Dungen, E.S.R. van den, Pereira, A.M., Hunt, H.J., Hofland, L.J., Meijer, O.C., Endocrinology, Amsterdam Gastroenterology Endocrinology Metabolism, and Internal Medicine

Subjects
Endocrinology, SDG 3 - Good Health and Well-being, Cushing’s syndrome, Endocrinology, Diabetes and Metabolism, HPA axis, glucocorticoid receptor, Cushing's syndrome, pituitary
Abstract

Glucocorticoid stress hormones are produced in response to hypothalamic-pituitary-adrenal (HPA) axis activation. Glucocorticoids are essential for physiology and exert numerous actions via binding to the glucocorticoid receptor (GR). Relacorilant is a highly selective GR antagonist currently undergoing a phase 3 clinical evaluation for the treatment of endogenous Cushing's syndrome. It was found that increases in serum adrenocorticotropic hormone (ACTH) and cortisol concentrations after relacorilant treatment were substantially less than the increases typically observed with mifepristone, but it is unclear what underlies these differences. In this study, we set out to further preclinically characterize relacorilant in comparison to the classical but non-selective GR antagonist mifepristone. In human HEK-293 cells, relacorilant potently antagonized dexamethasone- and cortisol-induced GR signaling, and in human peripheral blood mononuclear cells, relacorilant largely prevented the anti-inflammatory effects of dexamethasone. In mice, relacorilant treatment prevented hyperinsulinemia and immunosuppression caused by increased corticosterone exposure. Relacorilant treatment reduced the expression of classical GR target genes in peripheral tissues but not in the brain. In mice, relacorilant induced a modest disinhibition of the HPA axis as compared to mifepristone. In line with this, in mouse pituitary cells, relacorilant was generally less potent than mifepristone in regulating Pomc mRNA and ACTH release. This contrast between relacorilant and mifepristone is possibly due to the distinct transcriptional coregulator recruitment by the GR. In conclusion, relacorilant is thus an efficacious peripheral GR antagonist in mice with only modest disinhibition of the HPA axis, and the distinct properties of relacorilant endorse the potential of selective GR antagonist treatment for endogenous Cushing's syndrome.

Published
2023

39. Mapping of the current transition of care practice for patients with pituitary disease at Endo-ERN reference centers

Author

Shishkov, S.R., Tuccillo, L., Iotova, V.M., Pivonello, R., Pelsma, I.C.M., Pereira, A.M., Biermasz, N.R., Endo-ERN Reference Cemters of the Main Thematic Group: Hypothalamic and Pituitary Conditions, Endo-ERN Pituitary Transition of Care Study Group, Shishkov, Savi R, Tuccillo, Luigi, Iotova, Violeta M, Pivonello, Rosario, Pelsma, Iris Cm, Pereira, Alberto M, Biermasz, Nienke R, Endocrinology, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Endocrinology, pituitary disease, transition of care, quality of care, Endocrinology, Diabetes and Metabolism, Internal Medicine, Endo-ERN, survey
Abstract

Rare endocrine conditions present specific diagnostic and management challenges for healthcare providers, one of which is the understudied transition of care. Despite the need for guidance regarding transition, consensus on structured and protocolled approaches is lacking. Therefore, we aimed to map the current clinical practice and identify unmet needs regarding transition of care for patients with pituitary disease in the reference centers (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN). A survey-based, cross-sectional study using the EU Survey tool was performed and completed by 46 physicians (n) from 30 RCs (N). Transition is a common practice among RCs (n = 44/46), usually accomplished by a multidisciplinary team meeting (N = 20/30). Criteria for start and end of transition were defined in half of the RCs, with 16.7% of centers providing dissimilar answers. Transition readiness was assessed by >75% of the RCs, mostly by unvalidated means (e.g. subjective opinions, informal consultations). Pituitary-specific transition assessment tool was applied in one RC only. Transition protocols were present in only 9% of RCs, while in many RCs, transition decisions were taken in combined adult-pediatric meetings or based on clinicians’ personal judgment. A minority of physicians evaluated the effectiveness of transition-related interventions (n = 11/46) or medical outcomes (n = 8/46). Patient-reported outcome measures were infrequently used (n = 4/46). Identified unmet needs included the development of guidelines (n = 5/46) and EU-wide approach (n = 2/46). This study exemplifies the unmet needs for a structural definition of the transition period and transition management for patients with rare hypothalamic and pituitary conditions from healthcare providers’ perspective.

Published
2023

40. Magnetostriction in Amorphous Co66Fe34 Microcantilevers Fabricated with Hydrogenated Amorphous Silicon

Author

Silveira B.M., Belo J.H., Pinto R., Silva J.A., Ferreira T.D., Pires A.L., Chu V., Conde J.P., Frazão O., and Pereira A.M.

Subjects
magnetostriction, thin films, micromechanical & nanomechanical oscillators, functional materials, evaporation, bending, Physics, QC1-999
Abstract

To study the magnetostriction of Co66Fe34 thin films, amorphous silicon microcantilevers were prepared by surface micromachining, and the 136 nm-thick magnetostrictive film was deposited by electron beam physical vapor deposition and patterned on top of the microcantilever structure. The magnetostriction of the Co66Fe34 films was confirmed by measuring the deflection of the cantilevers under a varying magnetic field, reaching displacements up to 8 nm. The configuration was simulated using COMSOL software, yielding a similar deflection behavior as a function of the magnetic field, with a film with a magneto strictive coefficient of λ S ~ 55 p.p.m. The experimental configuration uses a laser and a position sensitive detector to measure the displacement, based on an optical lever configuration, and a piezoelectric stage to calibrate the system.

Published
2020
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41. Reply

Author

Scholz, P., Altay, L., Sitnilska, V., Dijk, E.H.C. van, Pereira, A.M., Haalen, F.M. van, Akhtar, I., Boon, C.J.F., and Fauser, S.

Published
2022

47. Implementation of functional imaging using C-11-methionine PET-CT co-registered with MRI for advanced surgical planning and decision making in prolactinoma surgery

Author

Bakker, L.E.H., Verstegen, M.J.T., Ghariq, E., Verbist, B.M., Schutte, P.J., Bashari, W.A., Kruit, M.C., Pereira, A.M., Gurnell, M., Biermasz, N.R., Furth, W.R. van, Bouda, L.M.P.A., Endocrinology, Amsterdam Gastroenterology Endocrinology Metabolism, Neurosurgery, Pereira, Alberto M [0000-0002-1194-9866], Bouda, Lenka M Pereira Arias [0000-0002-6879-5554], and Apollo - University of Cambridge Repository

Subjects
Positron emission tomography, Endocrinology, Diabetes and Metabolism, Surgical decision making, Dopamine agonist intolerance, Decision Making, Pituitary Neoplasms/diagnostic imaging, Positron-Emission Tomography/methods, Magnetic Resonance Imaging, Magnetic Resonance Imaging/methods, Prolactinoma/diagnostic imaging, Endocrinology, Methionine, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Transsphenoidal surgery, Humans, Pituitary Neoplasms, Prolactinoma, Functional imaging, Retrospective Studies
Abstract

Purpose To report the first experience of our multidisciplinary team with functional imaging using 11C-methionine positron emission tomography-computed tomography (11C-methionine PET-CT) co-registered with MRI (Met-PET/MRICR) in clinical decision making and surgical planning of patients with difficult to treat prolactinoma. Methods In eighteen patients with prolactinoma, referred to our tertiary referral centre because of intolerance or resistance for dopamine agonists (DA), Met-PET/MRICR was used to aid decision-making regarding therapy. Results Met-PET/MRICR was positive in 94% of the patients. MRI and Met-PET/MRICR findings were completely concordant in five patients, partially concordant in nine patients, and non-concordant in four patients. In five patients Met-PET/MRICR identified lesion(s) that were retrospectively also visible on MRI. Met-PET/MRICR was false negative in one patient, with a cystic adenoma on conventional MRI. Thirteen patients underwent transsphenoidal surgery, with nine achieving full biochemical remission, two clinical improvement and near normalized prolactin levels, and one patient clinical improvement with significant tumour reduction. Hence, nearly all patients (94%) were considered to have a positive outcome. Permanent complication rate was low. Three patients continued DA, two patients have a wait and scan policy. Conclusion Met-PET/MRICR can provide additional information to guide multidisciplinary preoperative and intraoperative decision making in selected cases of prolactinoma. This approach resulted in a high remission rate with a low rate of complications in our expert centre.

Published
2022

49. Current clinical practice for thromboprophylaxis management in patients with Cushing's syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

Author

Haalen, F.M. van, Kaya, M., Pelsma, I.C.M., Dekkers, O.M., Biermasz, N.R., Cannegieter, S.C., Huisman, M.V., Vlijmen, B.J.M. van, Feelders, R.A., Ven, A. van der, Klok, F.A., Pereira, A.M., Haalen, F.M. van, Kaya, M., Pelsma, I.C.M., Dekkers, O.M., Biermasz, N.R., Cannegieter, S.C., Huisman, M.V., Vlijmen, B.J.M. van, Feelders, R.A., Ven, A. van der, Klok, F.A., and Pereira, A.M.

Abstract

Item does not contain fulltext, BACKGROUND: Cushing's syndrome (CS) is associated with an hypercoagulable state and an increased risk of venous thromboembolism (VTE). Evidence-based guidelines on thromboprophylaxis strategies in patients with CS are currently lacking. We aimed to map the current clinical practice for thromboprophylaxis management in patients with CS across reference centers (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN), which are endorsed specifically for the diagnosis and treatment of CS. Using the EU survey tool, a primary screening survey, and subsequently a secondary, more in-depth survey were developed. RESULTS: The majority of the RCs provided thromboprophylaxis to patients with CS (n = 23/25), although only one center had a standardized thromboprophylaxis protocol (n = 1/23). RCs most frequently started thromboprophylaxis from CS diagnosis onwards (n = 11/23), and the majority stopped thromboprophylaxis based on individual patient characteristics, rather than standardized treatment duration (n = 15/23). Factors influencing the initiation of thromboprophylaxis were 'medical history of VTE' (n = 15/23) and 'severity of hypercortisolism' (n = 15/23). Low-Molecular-Weight-Heparin was selected as the first-choice anticoagulant drug for thromboprophylaxis by all RCs (n = 23/23). Postoperatively, the majority of RCs reported 'severe immobilization' as an indication to start thromboprophylaxis in patients with CS (n = 15/25). Most RCs (n = 19/25) did not provide standardized testing for variables of hemostasis in the postoperative care of CS. Furthermore, the majority of the RCs provided preoperative medical treatment to patients with CS (n = 23/25). About half of these RCs (n = 12/23) took a previous VTE into account when starting preoperative medical treatment, and about two-thirds (n = 15/23) included 'reduction of VTE risk' as a goal of treatment. CONCLUSIONS: There is a large practice variation regarding thromboprophylaxis management and perio

Published
2022

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