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- Title
Treatment with high doses of pegvisomant in 56 patients with acromegaly: experience from ACROSTUDY.
- Authors
van der Lely, Aart Jan; Jönsson, Peter; Wilton, Patrick; Åkerblad, Ann-Charlotte; Cara, José; Ghigo, Ezio
- Abstract
Objective: To investigate the characteristics of patients who need more or less pegvisomant (PEGV) to normalize serum IGF-I. Design: ACROSTUDY is a global noninterventional safety surveillance study of long-term treatment outcomes in patients treated with PEGV. As of June, 2014, ACROSTUDY included data on 2016 patients. All patients treated for at least 6 weeks at a dose above 30 mg/day and who had two consecutive normal serum IGF-I values were included in the 'high'-dose group (H; n = 56; mean daily dose 44 ± 12.5; median dose 40, 35-60 (10-90%)). Patients with two consecutive normal IGF-I values and who never received a PEGV dose above 10 mg/day were included in the 'low'-dose group (L; n = 368; mean daily dose 7.5 ± 2.5; median dose 8.6, 4.3-10 (10-90%)). Results: Patients in the H group were significantly younger (median 47 vs 52 years) and had a significantly higher BMI (median 31.8 vs 26.5 kg/m2). They had more diabetes (55% vs 21%), sleep apnea (25% vs 14%) and more hypertension (61% vs 43%). The incidence of (serious) adverse events was low and was not different between the groups. Conclusions: Patients who need more PEGV to normalize IGF-I have more aggressive disease, as they are younger, have higher baseline IGF-I levels, more hypertension, more sleep apnea and diabetes and are more overweight. A better understanding of this dose-efficacy relationship of PEGV might avoid inappropriate dosing and prevent serum IGF-I levels from remaining unnecessarily uncontrolled.
- Subjects
SOMATOMEDIN C; DIABETES; HYPERTENSION; SLEEP apnea syndromes; PATIENTS
- Publication
European Journal of Endocrinology, 2016, Vol 175, Issue 4, p239
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-16-0008