University of Padua

Paradoxical response to GH predicts glucose metabolism alterations in acromegaly

Occhi, Gianluca and Ceccato, Filippo (2024) Paradoxical response to GH predicts glucose metabolism alterations in acromegaly. [Data Collection]

Related publications

This is the latest version of this item.

Available Versions of this Item

Collection description

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/
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
Type of data: Database
Collection period:
Resource language: english
Metadata language: english
Publisher: Research Data Unipd
Related publications:
Date: 11 January 2024
Copyright holders: The Author

Available Files

Full Archive

Cite As

Begin typing (e.g. Chicago or IEEE.) or use the drop down menu.

Begin typing (e.g. en-GB for English, Great Britain) or use the drop down menu.

Export As