Comparison between Six-Year Therapy with Long-Acting Somatostatin Analogs and Successful Surgery in Acromegaly: Effects on Cardiovascular Risk Factors

Ronchi, Cristina L.; Varca, Virginia; Beck‐Peccoz, Paolo; Orsi, Emanuela; Donadio, F; Baccarelli, Andrea; Giavoli, Claudia; Ferrante, E.; Lania, Andrea; Spada, Anna; Arosio, Maura

doi:10.1210/jc.2005-1704

Cited by 89 publications

(86 citation statements)

References 45 publications

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“…Basal fasting insulin and stimulated insulin secretion levels (measured by HOMA-β) decreased. Insulin sensitivity measured by HOMA-IR, quantitative insulin check index (QUICKI) and composite index derived from OGTT (OGTT ISI ) decreased significantly (Ronchi et al, 2006).…”

Section: Glucose Metabolism-mentioning

confidence: 99%

“…If considering only GH levels <1 μg/L to be the cutoff for "normalizing" mortality, 33% of octreotide LAR Cozzi et al, 2003;Lancranjan and Atkinson, 1999;Lancranjan et al, 1996) and 25% of lanreotide SR Chanson et al, 2000a) treated patients achieved disease control, implying that ~50% of SRIF agonist treated GH-"controlled" patients may still be at higher risk for higher mortality rates. Prolonged treatment duration improves biochemical control as GH and IGF-1 plasma levels continue to decrease with time Colao et al, 2001;Cozzi et al, 2003Cozzi et al, ,2006Davies et al, 1998;Freda et al, 2005;Jallad et al, 2005;Ronchi et al, 2006). Primary pharmacotherapy is an optional treatment for selected patients (Ben-Shlomo and Melmed, 2003;Colao et al, 2006b).…”

Section: Biochemical Controlmentioning

confidence: 99%

“…In a retrospective analysis 36 patients treated with either drug for a median period of 66 months were analyzed for glucose metabolism as compared to 33 cured acromegaly patients (Ronchi et al, 2006). In the groups treated and responding to long-acting SRL fasting glucose levels and AUC of glucose levels during an OGTT were increased and HbA 1C increased ~1% (from 5 to 6%).…”

Section: Glucose Metabolism-mentioning

confidence: 99%

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Somatostatin agonists for treatment of acromegaly

Ben-Shlomo

Melmed

2008

Molecular and Cellular Endocrinology

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The discovery of somatotropin-release inhibitory factor (SRIF) in hypothalamic extract in 1970 led to the synthesis of the first somatostatin analog octreotide, discovery of five somatostatin receptor subtypes, and development of additional somatostatin receptor ligands (SRL) as pharmacotherapy for acromegaly and other neuroendocrine tumors. Long-acting formulations of SRL (octreotide LAR Depot, lanreotide SR and lanreotide autogel) assure improved patient compliance with weekly up to monthly injections, and are commonly used as primary or adjuvant treatment of acromegaly. We review SRL currently available, emphasizing long-acting compounds and their efficacy in controlling acromegaly. Disease control is evaluated by biochemical markers, tumor shrinkage, and diseasesymptom improvement balanced against drug-related side effects.

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Section: Glucose Metabolism-mentioning

confidence: 99%

Section: Biochemical Controlmentioning

confidence: 99%

Section: Glucose Metabolism-mentioning

confidence: 99%

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Somatostatin agonists for treatment of acromegaly

Ben-Shlomo

Melmed

2008

Molecular and Cellular Endocrinology

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“…They also act on the liver to block the synthesis of IGF1 (4). In about 60% of patients treated with SSTA, biochemical control can be achieved (5,6). Other medical treatment options include GH receptor antagonists and dopamine agonists.…”

Section: Introductionmentioning

confidence: 99%

Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly

Postma

Netea‐Maier²,

Berg³

et al. 2012

European Journal of Endocrinology

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Objective: To assess the influence of long-acting somatostatin analogs (SSTA) after initial pituitary surgery on long-term health-related quality of life (HR-QoL) in relation to disease control in patients with acromegaly. Design: This is a cross-sectional study in two tertiary referral centers in The Netherlands. Patients and methods: One hundred and eight patients with acromegaly, in whom transsphenoidal (nZ101, 94%) or transcranial (nZ7, 6%) surgery was performed. Subsequently, 46 (43%) received additional radiotherapy and 41 (38%) were on postoperative treatment with SSTA because of persistent or recurrent disease at the time of study. All subjects filled in standardized questionnaires measuring HR-QoL. Disease control at the time of study was assessed by local IGF1 SDS. Results: IGF1 SDS were slightly higher in patients treated with SSTA in comparison with patients without use of SSTA (0.85G1.52 vs 0.25G1.21, PZ0.026), but the percentage of patients with insufficient control (IGF1 SDS O2) was not different (17 vs 9%, PZ0.208). Patients using SSTA reported poorer scores on most subscales of the RAND-36 and the acromegaly QoL and on all subscales of the multidimensional fatigue inventory-20. A subgroup analysis in patients with similar IGF1 levels (SSTAC, nZ26, IGF1 SDS 0.44G0.72 vs SSTAK, nZ44, IGF1 SDS 0.41G0.65) revealed worse scores on physical functioning, physical fatigue, reduced activity, vitality, and general health perception across all HR-QoL questionnaires in patients treated with SSTA. Conclusion: QoL is impaired in association with the need for prolonged postoperative therapy by SSTA in patients with acromegaly despite similar IGF1 levels.

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“…Additionally, it is well documented that control of the disease improves glucose homeostasis (9)(10)(11)(12)(13) and reduces cardiovascular morbidity risk (12,13).…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitusin a cohort of patients with acromegaly

Rodrigues

Costenaro

Fedrizzi

et al. 2011

Arq Bras Endocrinol Metab

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Objectives: To evaluate the presence of diabetes mellitus (DM) in a cohort of patients with acromegaly. Methods: This was a cross sectional study. Results: Fifty-eight acromegalic patients were assessed. Only 29% met the criteria for cure, and 27% had the disease controlled. Twenty-two had DM; HbA1c was equal to 7.34 ± 2.2%. Most of the diabetic patients (18 out of 22, 82%) did not meet criteria for cure. They were more often hypertensive [16/22 (73%)

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Comparison between Six-Year Therapy with Long-Acting Somatostatin Analogs and Successful Surgery in Acromegaly: Effects on Cardiovascular Risk Factors

Cited by 89 publications

References 45 publications

Somatostatin agonists for treatment of acromegaly

Somatostatin agonists for treatment of acromegaly

Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly

Diabetes mellitusin a cohort of patients with acromegaly

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