Brazilian multicenter study on pegvisomant treatment in acromegaly
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| Main Author: | |
|---|---|
| Publication Date: | 2019 |
| Other Authors: | , , , , , , , , , , , , , |
| Format: | Article |
| Language: | eng |
| Source: | Repositório Institucional da UnB |
| Download full: | https://repositorio.unb.br/handle/10482/36696 https://doi.org/10.20945/2359-3997000000159 http://orcid.org/0000-0001-7285-7941 http://orcid.org/0000-0002-1042-5083 http://orcid.org/0000-0003-4815-6963 http://orcid.org/0000-0002-3363-3803 http://orcid.org/0000-0002-5686-7899 http://orcid.org/0000-0002-6114-5786 http://orcid.org/0000-0001-5083-5776 http://orcid.org/0000-0003-4804-1525 http://orcid.org/0000-0003-2405-0013 http://orcid.org/0000-0002-0113-5201 http://orcid.org/0000-0003-0477-1892 http://orcid.org/0000-0002-3495-1301 http://orcid.org/0000-0003-1562-4476 http://orcid.org/0000-0003-1339-3192 http://orcid.org/0000-0002-9250-3558 |
Summary: | 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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