Pegvisomant in acromegaly: a multicenter real-life study in Argentina.

Autor:	Basavilbaso NXG; Departamento de Endocrinología Hospital Carlos G. Durand, CABA, Argentina., Ballarino MC; Servicio de Endocrinología Hospital Militar Central, CABA, Argentina., Bruera D; Servicio de Endocrinología Clínica Caraffa, Córdoba, Argentina., Bruno OD; Servicio de Endocrinología Hospital de Clínicas 'José de San Martín', Universidad de Buenos Aires, CABA, Argentina., Chervin AB; Servicio de Endocrinología Hospital Santa Lucía, CABA, Argentina., Danilowicz K; Servicio de Endocrinología Hospital de Clínicas 'José de San Martín', Universidad de Buenos Aires, CABA, Argentina., Fainstein-Day P; Servicio de Endocrinología Hospital Italiano, CABA, Argentina., Fidalgo SG; Servicio de Endocrinología Hospital Churruca, CABA, Argentina., Frigeri A; Servicio de Endocrinología Hospital Teodoro Alvarez, CABA, Argentina., Glerean M; Servicio de Endocrinología Hospital Italiano, CABA, Argentina., Guelman R; Servicio de Endocrinología Hospital Italiano, CABA, Argentina., Isaac G; Servicio de Endocrinología Hospital Privado de la Comunidad, Mar del Plata, Argentina., Katz DA; Servicio de Endocrinología Fleni, CABA, Argentina., Knoblovits P; Servicio de Endocrinología Hospital Italiano, CABA, Argentina., Librandi F; Servicio de Endocrinología Hospital Rivadavia, CABA, Argentina., Montes ML; Servicio de Endocrinología Hospital Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina., Mallea-Gil MS; Servicio de Endocrinología Hospital Militar Central, CABA, Argentina., Manavela M; Servicio de Endocrinología Hospital de Clínicas 'José de San Martín', Universidad de Buenos Aires, CABA, Argentina., Mereshian P; Servicio de Endocrinología Hospital Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina., Moncet D; Servicio de Endocrinología Hospital Privado de la Comunidad, Mar del Plata, Argentina., Pignatta A; Servicio de Endocrinología Hospital Interzonal San Juan Bautista, La Rioja, Argentina., Rogozinsky A; Servicio de Endocrinología Hospital Ramos Mejía, CABA, Argentina., Sago LR; Servicio de Endocrinología Hospital Italiano de La Plata, La Plata, Argentina., Servidio M; Servicio de Endocrinología Hospital Teodoro Alvarez, CABA, Argentina., Spezzi M; Servicio de Endocrinología Instituto Médico Platense, Mar del Plata, Argentina., Stalldecker G; Servicio Hospital. Pirovano, CABA, Argentina., Tkatch J; Departamento de Endocrinología Hospital Carlos G. Durand, CABA, Argentina., Vitale NM; Servicio de Endocrinología Hospital Santa Lucía, CABA, Argentina., Guitelman M; Departamento de Endocrinología Hospital Carlos G. Durand, CABA, Argentina.
Jazyk:	angličtina
Zdroj:	Archives of endocrinology and metabolism [Arch Endocrinol Metab] 2019 Aug 22; Vol. 63 (4), pp. 320-327. Date of Electronic Publication: 2019 Aug 22.
DOI:	10.20945/2359-3997000000160
Abstrakt:	Objective: To describe the long term safety and efficacy of pegvisomant (PEGV), and the predictors of treatment response in patients with acromegaly in the real life setting. Subjects and Methods: We retrospectively reviewed the clinical, hormonal and radiological data of acromegalic patients treated with PEGV in 17 Argentine centers. Results: Seventy-five patients (age range 22-77, 51 females) with acromegaly have been treated with PEGV for up to 118 months (median 27 months). Before PEGV, 97.3% of patients had been treated with medical therapy, surgery and/or radiotherapy, two patients had no previous treatment. At that time, all patients had an IGF-1 above the upper normal limit (ULN) (mean 2.4 x ULN ± 0.98, range 1.25-7). At diagnosis of acromegaly 84% presented macroadenomas, prior to PEGV only 23,5% of patients remained with tumor remnant > 1 cm, the remaining showed normal or less than 1 cm images. Disease control (IGF-1 ≤ 1.2 x ULN) was achieved in 62.9% of patients with a mean dose of 11.8 mg/day. Thirty-four patients (45%) received PEGV monotherapy, while 41 (55%) received combined therapy with either somatostatin analogues and/or cabergoline. Adverse events related to PEGV were: local injection site reaction in 5.3%, elevated liver enzymes in 9.3%, and tumor size growth in 9.8%. Pre-PEGV IGF-I level was the only predictor of treatment response: 2.1 x ULN vs 2.8 x ULN in controlled and uncontrolled patients respectively (p < 0.001). Conclusion: this long term experience indicates PEGV treatment was highly effective and safe in our series of Argentine patients with acromegaly refractory to standard therapies. Arch Endocrinol Metab. 2019;63(4):320-7.
Databáze:	MEDLINE
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