PMID- 31613969
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 105
IP  - 3
DP  - 2020 Mar 1
TI  - Effects of Pegvisomant and Pasireotide LAR on Vertebral Fractures in Acromegaly 
      Resistant to First-generation SRLs.
LID - dgz054 [pii]
LID - 10.1210/clinem/dgz054 [doi]
AB  - PURPOSE: Osteopathy is an emerging complication of acromegaly. In somatostatin 
      receptor ligands (SRL)-resistant patients, pegvisomant (PegV) and pasireotide LAR 
      (Pasi) are used for acromegaly treatment, but their effect on skeletal health is 
      still not defined. METHODS: In a longitudinal retrospective international study, 
      we evaluated incidence of radiological vertebral fractures (VFs) in 55 patients 
      with acromegaly resistant to first-generation SRL. RESULTS: At study entry, 
      prevalent VFs occurred in 23 patients (41.8%). Biochemical acromegaly control was 
      reached in 66.7% of patients on PegV and in 66.7% of patients on Pasi. During the 
      follow-up, incident VFs (iVFs) were detected in 16 patients (29.1%). Occurrence 
      of iVFs was associated with prevalent VFs (P = .002), persistence of active 
      acromegaly (P = .01) and higher value of insulin-like growth factor 1 (IGF-1) 
      during follow-up (P = .03). Among patients with active disease at last visit, 
      iVFs occurred less frequently in patients on treatment with Pasi (25%) compared 
      to PegV (77.8% P = .04), independently of the IGF-1 values (P = .90). In patients 
      who reached biochemical control, 22.7% on PegV and 12.5% on Pasi had iVFs (P = 
      .40). Among both treatment groups, the presence of pre-existent VFs was the main 
      determinant for iVFs. CONCLUSION: Our data show for the first time that patients 
      with biochemically active disease treated with Pasi had lower risk of iVFs versus 
      those treated with PegV. It also confirms that the presence of pre-existent VFs 
      was the main determinant for iVFs. Additional studies on larger populations and 
      with longer follow-up are needed to confirm our data and disclose the mechanisms 
      underlying our findings.
CI  - (c) Endocrine Society 2019. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Chiloiro, Sabrina
AU  - Chiloiro S
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Giampietro, Antonella
AU  - Giampietro A
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Frara, Stefano
AU  - Frara S
AD  - Vita-Salute San Raffaele University, Milano, Italy.
FAU - Bima, Chiara
AU  - Bima C
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Donfrancesco, Federico
AU  - Donfrancesco F
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Fleseriu, Cara Maya
AU  - Fleseriu CM
AD  - University of Pittsburgh, Pittsburgh, PA, US.
AD  - Oregon Health and Science University, Portland, OR, US.
FAU - Pontecorvi, Alfredo
AU  - Pontecorvi A
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Giustina, Andrea
AU  - Giustina A
AD  - Vita-Salute San Raffaele University, Milano, Italy.
FAU - Fleseriu, Maria
AU  - Fleseriu M
AD  - Oregon Health and Science University, Portland, OR, US.
FAU - De Marinis, Laura
AU  - De Marinis L
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Bianchi, Antonio
AU  - Bianchi A
AD  - Pituitary Unit, Divisione di Endocrinologia, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore, Rome, Italy.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Hormones)
RN  - 0 (Receptors, Somatostatin)
RN  - 12629-01-5 (Human Growth Hormone)
RN  - 51110-01-1 (Somatostatin)
RN  - 98H1T17066 (pasireotide)
RN  - N824AOU5XV (pegvisomant)
SB  - IM
MH  - Acromegaly/*drug therapy/pathology
MH  - Adult
MH  - Case-Control Studies
MH  - *Drug Resistance
MH  - Female
MH  - Follow-Up Studies
MH  - Hormones/*pharmacology
MH  - Human Growth Hormone/*analogs & derivatives/pharmacology
MH  - Humans
MH  - International Agencies
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Receptors, Somatostatin/*agonists
MH  - Retrospective Studies
MH  - Somatostatin/*analogs & derivatives/pharmacology
MH  - Spinal Fractures/*prevention & control
EDAT- 2019/10/16 06:00
MHDA- 2020/11/11 06:00
CRDT- 2019/10/16 06:00
PHST- 2019/06/25 00:00 [received]
PHST- 2019/09/25 00:00 [accepted]
PHST- 2019/10/16 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2019/10/16 06:00 [entrez]
AID - 5588033 [pii]
AID - 10.1210/clinem/dgz054 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2020 Mar 1;105(3):dgz054. doi: 10.1210/clinem/dgz054.