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. 2024 Aug;47(8):1887-1901.
doi: 10.1007/s40618-023-02299-7. Epub 2024 Mar 26.

Long-term pasireotide therapy in acromegaly: extensive real-life experience of a referral center

R Pirchio  1 , R S Auriemma  1 , A Vergura  1 , R Pivonello  1   2 , A Colao  3   4
Affiliations

Long-term pasireotide therapy in acromegaly: extensive real-life experience of a referral center

R Pirchio et al. J Endocrinol Invest. 2024 Aug.

Abstract

Purpose: Pasireotide is a novel therapeutic option for patients with acromegaly resistant to first-generation somatostatin receptor ligands. To date, real-life data are still scant, therefore, the aim of the current study is to evaluate the impact of long-term pasireotide therapy on disease control, pituitary tumor size, gluco-insulinemic and lipid profile in a real-life setting.

Methods: Retrospective study of data prospectively collected, evaluating hormonal, tumoral, and metabolic data of 28 patients with acromegaly administered with pasireotide in a pituitary tertiary referral center.

Results: Within the first 12 months of treatment, 70.4% of patients achieved normal IGF-I levels, which was maintained at 36-month evaluation in these responders patients. Patients who started with pasireotide 60 mg monthly exhibited significantly lower IGF-I levels after 36 months (p = 0.05) as compared to patients administered first with pasireotide 20 or 40 mg monthly. The maximal tumoral diameter was significantly decreased after 12 months of pasireotide (p < 0.001) and a further reduction was registered throughout the following months, with 41.2% of patients achieving a significant reduction (> 25% of baseline measurement) after 36 months of treatment. Fasting glucose significantly increased during the first 6 months (p < 0.001) with a gradual rise in diabetes prevalence during the following months, resulting diabetes prevalence after 36 months of pasireotide significantly increased compared to baseline (p = 0.003), although with glycated hemoglobin levels within the normal range. Diabetes was managed using oral glucose-lowering drugs or glucagon-like peptide 1 agonists, with no patient requiring insulin therapy. Pasireotide improved lipid profile, mainly during the first 12 months of treatment, by increasing HDL and decreasing triglycerides levels.

Conclusion: Pasireotide is effective and safe in the long-term. Hyperglycemia is a common event and is manageable even without insulin treatment.

Keywords: Acromegaly; Glucose; Insulin; Lipid; Pasireotide; Pituitary tumor.

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Conflict of interest statement

AC has been Principal Investigator of Research Studies for Novartis, Ipsen, Pfizer, Lilly, Merck and Novo Nordisk; consultant for Novartis, Ipsen, Pfizer, and received honoraria from Novartis, Ipsen and Pfizer beyond the confines of this work. RPiv has been Principal Investigator of Clinical and/or Translational Research Studies for Novartis, HRA Pharma, Ipsen, Shire, Corcept Therapeutics, Cortendo AB, Janssen Cilag, Camurus, Strongbridge, and Pfizer; Co-investigator of Research Studies for Pfizer; received research grants from Novartis, Pfizer, Ipsen, HRA Pharma, Shire, IBSA, Strongbridge Biopharma; has been an occasional consultant for Novartis, Ipsen, Pfizer, Shire, HRA Pharma, Cortendo AB, Ferring, Strongbridge Biopharma, Recordati, Corcept Therapeutics, Crinetics Pharmaceuticals, ARH Healthcare, Biohealth Italia, Italfarmaco; and has received fees and honoraria for presentations from Novartis, Shire, Pfizer and Recordati beyond the confines of this work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Details of the study population
Fig. 2
Fig. 2
Changes in GH and IGF-I levels throughout the study. * are provided when a significant difference compared to baseline was found
Fig. 3
Fig. 3
Changes in fasting glucose and HbA1c throughout the study. * are provided when a significant difference compared to baseline was found
Fig. 4
Fig. 4
Prevalence of normal glucose tolerance (NGT), impaired fasting glucose (IFG), and diabetes mellitus (DM) throughout the study
Fig. 5
Fig. 5
Changes in maximal tumor diameter throughout the study. * are provided when a significant difference compared to baseline was found
Fig. 6
Fig. 6
Per cent change (Δ%) in fasting glucose in the first 12 months of pasireotide (PAS) was directly correlated to patient’s age at pasireotide starting
See this image and copyright information in PMC

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References

    1. Colao A, Grasso LFS, Giustina A, Melmed S, Chanson P, Pereira AM, Pivonello R. (2019) Acromegaly. Nat Rev Dis Primers Mar 5 (1):20 - PubMed
    1. Giustina A, Barkhoudarian G, Beckers A, Ben-Shlomo A, Biermasz N, Biller B, Boguszewski C, Bolanowski M, Bollerslev J, Bonert V, Bronstein MD, Buchfelder M, Casanueva F, Chanson P, Clemmons D, Fleseriu M, Formenti AM, Freda P, Gadelha M, Geer E, Gurnell M, Heaney AP, Ho KKY, Ioachimescu AG, Lamberts S, Laws E, Losa M, Maffei P, Mamelak A, Mercado M, Molitch M, Mortini P, Pereira AM, Petersenn S, Post K, Puig-Domingo M, Salvatori R, Samson SL, Shimon I, Strasburger C, Swearingen B, Trainer P, Vance ML, Wass J, Wierman ME, Yuen KCJ, Zatelli MC, Melmed S (2020) Multidisciplinary management of acromegaly: A consensus. Rev Endocr Metab Disord. 10.1007/s11154-020-09588-z 10.1007/s11154-020-09588-z - DOI - PMC - PubMed
    1. Schmid HA, Schoeffter P (2004) (2004) Functional activity of the multiligand analog SOM230 at human recombinant somatostatin receptor subtypes supports its usefulness in neuroendocrine tumors. Neuroendocrinology 80(Suppl 1):47–50. 10.1159/000080741 10.1159/000080741 - DOI - PubMed
    1. Schmid HA (2008) Pasireotide (SOM230): development, mechanism of action and potential applications. Mol Cell Endocrinol. 10.1016/j.mce.2007.09.006 10.1016/j.mce.2007.09.006 - DOI - PubMed
    1. Colao A, Bronstein MD, Freda P, Gu F, Shen CC, Gadelha M, Fleseriu M, van der Lely AJ, Farrall AJ, Hermosillo Reséndiz K, Ruffin M, Chen Y, Sheppard M (2014) Pasireotide C2305 Study Group Pasireotide versus octreotide in acromegaly: a head-to-head superiority study. J Clin Endocrinol Metab. 10.1210/jc.2013-2480 10.1210/jc.2013-2480 - DOI - PMC - PubMed

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