Results from ACROCOVID: an international survey on the care of acromegaly during the COVID-19 era

Giustina, Andrea; Legg, Ewen; Cesana, Bruno Mario; Frara, Stefano; Mortini, Pietro; Fleseriu, Maria

doi:10.1007/s12020-020-02565-1

Cited by 24 publications

(31 citation statements)

References 43 publications

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“…The results of this survey also suggested that new approaches necessarily used by pituitary endocrinologists during the COVID-19 emergency such as remote consultations, that reduce the burden of hospital visits, may likely improve acromegaly patient care also in the post-pandemic environment [19].…”

Section: Acromegalymentioning

confidence: 84%

“…Development of DM in patients with acromegaly may increase their already elevated cardiovascular morbidity and mortality [18]. Moreover, the presence of COVID-19 induced DM may also impact on disease treatment [19], since somatostatin receptor ligands (SRLs) particularly pasireotide may directly influence glucose metabolism [20,21]. Therefore, blood glucose levels should be periodically monitored in patients treated with SRLs [22] to reduce and/or avoid hyperglycemic negative known impact on COVID-19 features, especially in those treated with intravenous glucocorticoids, the standard of care during COVID-19 second wave; in this context, treatment with Pegvisomant [23] has been reported to have more favourable effects on glucose homeostasis than SRLs [17] DM is also frequent and early complication of Cushing disease with relevant prognostic and therapeutic implications since DM may often be difficult to control and the SRL pasireotide which may be used to control endogenous hypercortisolism may negatively influence glucose homeostasis [24][25][26].…”

Section: Diabetes Mellitus (Dm)mentioning

confidence: 99%

“…Since the pandemic was reported to disrupt the usual care of many severe chronic conditions and limit hospital access for affected patients [100] we assessed the effects of COVID-19 in acromegaly care through an international online survey [19]. In general, endocrinologist respondents, most of whom were managing a large number of acromegaly patients, reported that COVID-19 emergency caused broad negative effects on the acromegaly care pathway.…”

Section: Acromegalymentioning

confidence: 99%

“…In general, endocrinologist respondents, most of whom were managing a large number of acromegaly patients, reported that COVID-19 emergency caused broad negative effects on the acromegaly care pathway. Marked delays in surgical interventions due to hospital services reorganization with a lack of surgical provision and limited access to pre-surgery COVID-19 testing, especially during first wave emergency were reported [19]. Difficulties in assessing treatment efficacy [101] with neuroradiological follow-up and monitoring of biochemical control as well as importantly of clinical signs and symptoms related to acromegaly and its associated comorbidities [102] were described [19].…”

Section: Acromegalymentioning

confidence: 99%

“…Marked delays in surgical interventions due to hospital services reorganization with a lack of surgical provision and limited access to pre-surgery COVID-19 testing, especially during first wave emergency were reported [19]. Difficulties in assessing treatment efficacy [101] with neuroradiological follow-up and monitoring of biochemical control as well as importantly of clinical signs and symptoms related to acromegaly and its associated comorbidities [102] were described [19]. In this context, the availability of effective medical therapies [103] often able to control both biochemical and tumoral parameters [104] may by of high value for clinicians particularly when self-administration is possible [103,105].…”

Section: Acromegalymentioning

confidence: 99%

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COVID-19 and the pituitary

et al. 2021

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Background Despite COVID-19 being identified as severe respiratory viral infection, progressively many relevant endocrine manifestations have been reported greatly contributing to the severity of the clinical presentation. Systemic involvement in COVID-19 is due to the ubiquitous expression of angiotensin-converting enzyme 2 (ACE2) receptor, responsible for the entry in the cells of SARS-CoV-2, Several reports in humans and animal models showed a significant ACE2 mRNA expression in hypothalamus and pituitary cells. Moreover, higher mortality and poorer outcomes have been widely described in COVID-19 patients with obesity, diabetes and vertebral fractures, which are all highly prevalent in subjects with pituitary dysfunctions. Aim To review the main endocrine manifestations of COVID-19 with their possible implications for pituitary diseases, the possible direct and indirect involvement of the pituitary gland in COVID-19, the impact of COVID-19 on the management of established pituitary diseases which can be already at increased risk for worse outcomes and on neurosurgical activities as well as vaccination. Conclusions Our review underlines that there could be a specific involvement of the pituitary gland which fits into a progressively shaping endocrine phenotype of COVID-19. Moreover, the care for pituitary diseases need to continue despite the restrictions due to the emergency. Several pituitary diseases, such as hypopituitarism and Cushing disease, or due to frequent comorbidities such as diabetes may be a risk factor for severe COVID-19 in affected patients. There is the urgent need to collect in international multicentric efforts data on all these aspects of the pituitary involvement in the pandemic in order to issue evidence driven recommendations for the management of pituitary patients in the persistent COVID-19 emergency.

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Section: Acromegalymentioning

confidence: 84%

Section: Diabetes Mellitus (Dm)mentioning

confidence: 99%

Section: Acromegalymentioning

confidence: 99%

Section: Acromegalymentioning

confidence: 99%

Section: Acromegalymentioning

confidence: 99%

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COVID-19 and the pituitary

et al. 2021

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The overall impact of COVID‐19 on healthcare during the pandemic: A multidisciplinary point of view

Sabetkish

Rahmani

2021

Health Science Reports

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Background and Aims The Coronavirus disease 2019 (COVID‐19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID‐19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post‐COVID era and the need for future medical revolutions. Methods A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. Results We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID‐19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check‐ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. Conclusion Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post‐COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.

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A systematic literature review to evaluate extended dosing intervals in the pharmacological management of acromegaly

et al. 2022

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Purpose This systematic literature review investigated whether extended dosing intervals (EDIs) of pharmacological acromegaly treatments reduce patient burden and costs compared with standard dosing, while maintaining effectiveness. Methods MEDLINE/Embase/the Cochrane Library (2001–June 2021) and key congresses (2018–2021) were searched and identified systematic literature review bibliographies reviewed. Included publications reported on efficacy/effectiveness, safety and tolerability, health-related quality of life (HRQoL), and patient-reported and economic outcomes in longitudinal/cross-sectional studies in adults with acromegaly. Interventions included EDIs of pegvisomant, cabergoline, and somatostatin receptor ligands (SRLs): lanreotide autogel/depot (LAN), octreotide long-acting release (OCT), pasireotide long-acting release (PAS), and oral octreotide; no comparator was required. Results In total, 35 publications reported on 27 studies: 3 pegvisomant monotherapy, 11 pegvisomant combination therapy with SRLs, 9 LAN, and 4 OCT; no studies reported on cabergoline, PAS, or oral octreotide at EDIs. Maintenance of normal insulin-like growth factor I (IGF-I) was observed in ≥ 70% of patients with LAN (1 study), OCT (1 study), and pegvisomant monotherapy (1 study). Achievement of normal IGF-I was observed in ≥ 70% of patients with LAN (3 studies) and pegvisomant in combination with SRLs (4 studies). Safety profiles were similar across EDI and standard regimens. Patients preferred and were satisfied with EDIs. HRQoL was maintained and cost savings were provided with EDIs versus standard regimens. Conclusions Clinical efficacy/effectiveness, safety, and HRQoL outcomes in adults with acromegaly were similar and costs lower with EDIs versus standard regimens. Physicians may consider acromegaly treatment at EDIs, especially for patients with good disease control.

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Results from ACROCOVID: an international survey on the care of acromegaly during the COVID-19 era

Cited by 24 publications

References 43 publications

COVID-19 and the pituitary

COVID-19 and the pituitary

The overall impact of COVID‐19 on healthcare during the pandemic: A multidisciplinary point of view

A systematic literature review to evaluate extended dosing intervals in the pharmacological management of acromegaly

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