Pasireotide Long-Acting Release Treatment for Diabetic Cats with Underlying Hypersomatotropism.

Autor: Gostelow, R., Scudder, C., Keyte, S., Forcada, Y., Fowkes, R.C., Schmid, H.A., Church, D.B., Niessen, S.J.M.
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Zdroj: Journal of Veterinary Internal Medicine; Mar/Apr2017, Vol. 31 Issue 2, p355-364, 10p
Abstrakt: Background Long-term medical management of hypersomatotropism ( HS) in cats has proved unrewarding. Pasireotide, a novel somatostatin analogue, decreases serum insulin-like growth factor 1 ( IGF-1) and improves insulin sensitivity in cats with HS when administered as a short-acting preparation. Objectives Assess once-monthly administration of long-acting pasireotide (pasireotide LAR) for treatment of cats with HS. Animals Fourteen cats with HS, diagnosed based on diabetes mellitus, pituitary enlargement, and serum IGF-1 > 1000 ng/mL. Methods Uncontrolled, prospective cohort study. Cats received pasireotide LAR (6-8 mg/kg SC) once monthly for 6 months. Fructosamine and IGF-1 concentrations, and 12-hour blood glucose curves ( BGCs) were assessed at baseline and then monthly. Product of fructosamine concentration and insulin dose was calculated as an indicator of insulin resistance (Insulin Resistance Index). Linear mixed-effects modeling assessed for significant change in fructosamine, IGF-1, mean blood glucose ( MBG) of BGCs, insulin dose (U/kg) and Insulin Resistance Index. Results Eight cats completed the trial. Three cats entered diabetic remission. Median IGF-1 (baseline: 1962 ng/mL [range 1051-2000 ng/mL]; month 6: 1253 ng/mL [524-1987 ng/mL]; P < .001) and median Insulin Resistance Index (baseline: 812 μmolU/L kg [173-3565 μmolU/L kg]; month 6: 135 μmolU/L kg [0-443 μmolU/L kg]; P = .001) decreased significantly. No significant change was found in mean fructosamine (baseline: 494 ± 127 μmol/L; month 6: 319 ± 113.3 μmol/L; P = .07) or MBG (baseline: 347.7 ± 111.0 mg/dL; month 6: 319.5 ± 113.3 mg/dL; P = .11), despite a significant decrease in median insulin dose (baseline: 1.5 [0.4-5.2] U/kg; 6 months: 0.3 [0.0-1.4] U/kg; P < .001). Adverse events included diarrhea (n = 11), hypoglycemia (n = 5), and worsening polyphagia (n = 2). Conclusions and Clinical Importance Pasireotide LAR is the first drug to show potential as a long-term management option for cats with HS. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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