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Pegvisomant in acromegaly: a multicenter real-life study in Argentina
- Source :
- Archives of Endocrinology and Metabolism, Volume: 63, Issue: 4, Pages: 320-327, Published: 22 AUG 2019, Archives of Endocrinology and Metabolism, Vol 63, Iss 4, Pp 320-327, Archives of Endocrinology and Metabolism v.63 n.4 2019, Arquivos de Endocrinologia e Metabolismo, Sociedade Brasileira de Endocrinologia e Metabologia (SBEM), instacron:SBEM
- Publication Year :
- 2019
- Publisher :
- Archives of Endocrinology and Metabolism, 2019.
-
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
- Subjects :
- Adult
Male
medicine.medical_specialty
Cabergoline
Endocrinology, Diabetes and Metabolism
Argentina
Pegvisomant
lcsh:Medicine
030209 endocrinology & metabolism
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Gastroenterology
Young Adult
03 medical and health sciences
0302 clinical medicine
Refractory
Predictive Value of Tests
Internal medicine
Acromegaly
medicine
Humans
Insulin-Like Growth Factor I
Adverse effect
Aged
Retrospective Studies
lcsh:RC648-665
Human Growth Hormone
business.industry
lcsh:R
GH receptor antagonist
clinical trial
Retrospective cohort study
Middle Aged
medicine.disease
Clinical trial
Treatment Outcome
030220 oncology & carcinogenesis
Predictive value of tests
Dopamine Agonists
acromegaly
Drug Therapy, Combination
Female
Somatostatin
business
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 23594292 and 23593997
- Volume :
- 63
- Database :
- OpenAIRE
- Journal :
- Archives of Endocrinology and Metabolism
- Accession number :
- edsair.doi.dedup.....106aacc89fa47c7414d0565d361889c3