Brazilian multicenter study on pegvisomant treatment in acromegaly
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...
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ir-10482-366962020-04-22T13:14:56Z Brazilian multicenter study on pegvisomant treatment in acromegaly Boguszewski, Cesar L. Huayllas, Martha Katherine P Vilar, Lucio Naves, Luciana Ansaneli Ribeiro-Oliveira Junior, Antonio Soares, Beatriz Santana Czepielewski, Mauro Antonio Abucham, Julio Correa-Silva, Silvia Regina Bronstein, Marcello Delano Jallad, Raquel Soares Duarte, Felipe Gaia Musolino, Nina Rosa Kasuki, Leandro Gadelha, Monica Roberto Acromegalia Somatotropina Pegvisomanto Estudo multicêntrico 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. 2020-01-24T10:33:18Z 2020-01-24T10:33:18Z 2019 Artigo BOGUSZEWSKI, Cesar L. et al. Brazilian multicenter study on pegvisomant treatment in acromegaly. Archives of Endocrinology and Metabolism, v. 63, n. 4, p. 328-336, 2019. DOI: https://doi.org/10.20945/2359-3997000000159. Disponível em: http://scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972019000700328. Acesso em: 23 jan. 2020. 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 en Acesso Aberto (CC BY) - This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. application/pdf Sociedade Brasileira de Endocrinologia e Metabologia |
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REPOSITORIO UNB |
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REPOSITORIO UNB |
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English |
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Acromegalia Somatotropina Pegvisomanto Estudo multicêntrico |
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Acromegalia Somatotropina Pegvisomanto Estudo multicêntrico Boguszewski, Cesar L. Huayllas, Martha Katherine P Vilar, Lucio Naves, Luciana Ansaneli Ribeiro-Oliveira Junior, Antonio Soares, Beatriz Santana Czepielewski, Mauro Antonio Abucham, Julio Correa-Silva, Silvia Regina Bronstein, Marcello Delano Jallad, Raquel Soares Duarte, Felipe Gaia Musolino, Nina Rosa Kasuki, Leandro Gadelha, Monica Roberto Brazilian multicenter study on pegvisomant treatment in acromegaly |
| description |
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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Artigo |
| author |
Boguszewski, Cesar L. Huayllas, Martha Katherine P Vilar, Lucio Naves, Luciana Ansaneli Ribeiro-Oliveira Junior, Antonio Soares, Beatriz Santana Czepielewski, Mauro Antonio Abucham, Julio Correa-Silva, Silvia Regina Bronstein, Marcello Delano Jallad, Raquel Soares Duarte, Felipe Gaia Musolino, Nina Rosa Kasuki, Leandro Gadelha, Monica Roberto |
| author_sort |
Boguszewski, Cesar L. |
| title |
Brazilian multicenter study on pegvisomant treatment in acromegaly |
| title_short |
Brazilian multicenter study on pegvisomant treatment in acromegaly |
| title_full |
Brazilian multicenter study on pegvisomant treatment in acromegaly |
| title_fullStr |
Brazilian multicenter study on pegvisomant treatment in acromegaly |
| title_full_unstemmed |
Brazilian multicenter study on pegvisomant treatment in acromegaly |
| title_sort |
brazilian multicenter study on pegvisomant treatment in acromegaly |
| publisher |
Sociedade Brasileira de Endocrinologia e Metabologia |
| publishDate |
2020 |
| url |
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 |
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1672205687459938304 |
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13.657419 |