| Combined treatment for acromegaly with long-acting somatostatin analogs and pegvisomant: long-term safety for up to 4.5 years (median 2.2 years) of follow-up in 86 patients. | |
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MedLine Citation:
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PMID: 19141604 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We previously reported on the efficacy, safety, and quality of life (QoL) of long-acting somatostatin analogs (SSA) and (twice) weekly pegvisomant (PEG-V) in acromegaly and improvement after the addition of PEG-V to long-acting SSA. OBJECTIVE: To assess the long-term safety in a larger group of acromegalic patients over a larger period of time: 29.2 (1.2-57.4) months (mean (range)). DESIGN: Pegvisomant was added to SSA monotherapy in 86 subjects (37 females), to normalize serum IGF1 concentrations (n=63) or to increase the QoL. The median dosage was 60.0 (20-200) mg weekly. RESULTS: After a mean treatment period of 29.2 months, 23 patients showed dose-independent PEG-V related transient liver enzyme elevations (TLEE). TLEE occurred only once during the continuation of combination therapy, but discontinuation and re-challenge induced a second episode of TLEE. Ten of these patients with TLEE also suffered from diabetes mellitus (DM). In our present series, DM had a 2.28 odds ratio (CI 1.16-9.22; p=0.03) higher risk for developing TLEE. During the combined therapy, a clinical significant decrease in tumor size by more than 20% was observed in 14 patients. Two of these patients were previously treated by pituitary surgery, 1 with additional radiotherapy and all other patients received primary medical treatment. CONCLUSION: Long-term combined treatment with SSA and twice weekly PEG-V up to more than 4 years seems to be safe. Patients with both acromegaly and DM have a 2.28 higher risk of developing TLEE. Clinical significant tumor shrinkage was observed in 14 patients during combined treatment. |
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Authors:
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S J C M M Neggers; W W de Herder; J A M J L Janssen; R A Feelders; A J van der Lely |
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Publication Detail:
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Type: Journal Article Date: 2009-01-13 |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 160 ISSN: 1479-683X ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-31 Completed Date: 2009-04-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 529-33 Citation Subset: IM |
Affiliation:
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Department of Medicine, Erasmus University, Erasmus MC, Rotterdam, The Netherlands. s.neggers@erasmusmc.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acromegaly
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drug therapy* Adult Aged Aged, 80 and over Diabetes Complications / physiopathology Drug Therapy, Combination Electrocardiography Female Follow-Up Studies Human Growth Hormone / adverse effects, analogs & derivatives*, therapeutic use Humans Liver Function Tests Male Middle Aged Octreotide / therapeutic use Peptides, Cyclic / therapeutic use Receptors, Somatotropin / antagonists & inhibitors* Somatostatin / adverse effects, analogs & derivatives*, therapeutic use* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Peptides, Cyclic; 0/Receptors, Somatotropin; 0/pegvisomant; 118992-92-0/lanreotide; 12629-01-5/Human Growth Hormone; 51110-01-1/Somatostatin; 83150-76-9/Octreotide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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