Occhi, Gianluca and Ceccato, Filippo (2024) Paradoxical response to GH predicts glucose metabolism alterations in acromegaly. [Data Collection]
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OGTT GH profile is predictive of a higher risk of glucose metabolism alterations in acromegaly treated with pasireotide. (deposited 11 Jan 2024 14:02)
- Paradoxical response to GH predicts glucose metabolism alterations in acromegaly. (deposited 22 Mar 2024 11:18) [Currently Displayed]
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Objective: A paradoxical increase in GH after oral glucose load (GH-Par) characterizes about one-third of acromegaly patients and is associated with a better response to first-generation somatostatin receptor ligands (fg-SRLs). Pasireotide is typically considered as a second-/third-line treatment. Here, we aimed to investigate the predictive role of GH-Par in Pasireotide response and the development of adverse events. Design: Multi-center Italian retrospective cohort of 78 patients treated for at least 3 months with Pasireotide. Results: IGF-1 median levels were 1.38 times the upper limit of normality (ULN) in patients with large (median 18 mm) and invasive (78%) adenomas after fg-SRL treatment failure. After a 37-month median treatment, Pasireotide effectively reduced IGF-1 ULN levels in 65 patients. Notably, 74% of cases experienced a ≥30% reduction, with normalization achieved in 58%. Among 59 patients with available OGTTs, 13 showed GH-Par (22%). Despite similar pre-Pasireotide IGF-1 levels, GH-Par patients more frequently exhibited >50% reduction in basal IGF-1 ULN after prior treatments compared to GH-NPar (83% vs 42%, p=0.02). The median Pasireotide duration (16.0 vs 24.5 months), dosage (40 vs 50 mg/monthly), and efficacy in reducing IGF-1 ULN (-49.5% vs -57.3%) were similar between the GH-Par and GH-NPar groups. Pasireotide was discontinued in 11 patients due to new-onset or worsening of glucose metabolism alterations, with higher incidence in GH-Par (77%) vs GH-NPar (37%) (p=0.011). Conclusions: The GH-Par does not predict the response to Pasireotide in acromegaly but can predict new-onset Pasireotide-induced glucose metabolism alterations.
| DOI: |  10.25430/researchdata.cab.unipd.it.00001165 |
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| Keywords: | acromegaly, IGF-1, GH profile, oral glucose tolerance test, pasireotide, glucose metabolism alterations | |||||||||
| Subjects: | Life Sciences > Physiology, Pathophysiology and Endocrinology: Organ physiology, pathophysiology, endocrinology, metabolism, ageing, tumorigenesis, cardiovascular diseases, metabolic syndromes > Fundamental mechanisms underlying cancer | |||||||||
| Department: | Departments > Dipartimento di Medicina (DIMED) | |||||||||
| Depositing User: | Filippo Ceccato | |||||||||
| Date Deposited: | 22 Mar 2024 11:18 | |||||||||
| Last Modified: | 22 Mar 2024 11:18 | |||||||||
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| Type of data: | Database | |||||||||
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| Resource language: | english | |||||||||
| Metadata language: | english | |||||||||
| Publisher: | Research Data Unipd | |||||||||
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| Date: | 11 January 2024 | |||||||||
| Copyright holders: | The Author | |||||||||
| URI: | https://researchdata.cab.unipd.it/id/eprint/1241 |
orcid.org/0000-0003-4065-4677
