Use of lanreotide in combination with cabergoline or pegvisomant in patients with acromegaly in the clinical practice: The ACROCOMB study
Por:
Puig-Domingo, M, Soto, A, Venegas, E, Vilchez, R, Blanco, C, Cordido, F, Lucas, T, Marazuela, M, Casany, R, Cuatrecasas, G, Fajardo, C, Galvez, MA, Maraver, S, Martin, T, Romero, E, Paja, M, Pico, A, Bernabeu, I, Resmini, E
Publicada:
1 oct 2016
Resumen:
Purpose: To describe real-world use of lanreotide combination therapy for acromegaly. Patients and methods: ACROCOMB is a retrospective observational Spanish study of patients with active acromegaly treated with lanreotide combination therapy between 2006 and 2011. 108 patients treated at 44 Spanish Endocrinology Departments were analyzed separately: 61 patients received lanreotide/cabergoline (cabergoline cohort) and 47 lanreotide/pegvisomant (pegvisomant cohort).
Results: Patient median age was 50.8 years in the cabergoline cohort and 42.7 years in the pegvisomant cohort. Prior medical treatments were somatostatin analogue (SSA) monotherapy (40 [66%] patients) or dopamine agonists (7 [11%] patients) in the cabergoline cohort and SSA (29 [62%] patients) or pegvisomant monotherapy (16 [34%] patients) in the pegvisomant cohort. Across both cohorts 12 patients were previously untreated, and prior therapy was unknown/missing in 4 patients. Median duration of combined treatment was 1.6 years (0.1-6) and 2.1 years (0.4-6.3) in the cabergoline and pegvisomant cohorts, respectively. At baseline, median insulin growth factor (IGF)-I values were 149% upper limit of normal (ULN) (15-505%) in the cabergoline cohort and 156% ULN (15-534%) in the pegvisomant cohort, and decreased to 104% ULN (13-557%) p < 0.001 and 86% ULN (23-345%) p < 0.0001, respectively, at end of study (EOS). Normal age-adjusted values of IGF-I were obtained in 48% of lanreotide/cabergoline-treated patients and 70% of lanreotide/pegvisomant-treated patients at EOS. There were no significant changes in hepatic, cardiac or glycaemic parameters in either cohort.
Conclusion: In clinical practice lanreotide treatment combinations are useful options for patients with acromegaly when monotherapy is insufficient; particularly, the combination of lanreotide and pegvisomant in patients not controlled with either SSA or pegvisomant alone has high efficacy and is well-tolerated. (C) 2016 SEEN. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Puig-Domingo, M:
Hosp Badalona Germans Trias & Pujol, Carretera Canyet S-N, Barcelona 08916, Spain
Soto, A:
Hosp Univ Virgen del Rocio, Ave Manuel Siurot 0, Seville 41013, Spain
Venegas, E:
Hosp Univ Virgen del Rocio, Ave Manuel Siurot 0, Seville 41013, Spain
Vilchez, R:
Hosp Univ Virgen de las Nieves, Ave Fuerzas Armadas 2, Granada 18014, Spain
Blanco, C:
Hosp Univ Principe de Asturias, Carretera Alcala Meco S-N, Madrid 28805, Spain
Cordido, F:
Univ Hosp A Coruna, As Xubias 84, La Coruna 15006, Spain
Lucas, T:
Hosp Univ Puerta de Hierro, Calle Manuel de Falla 1, Madrid 28222, Spain
Marazuela, M:
Hosp Univ La Princesa, Calle Diego Leon 62, Madrid 28006, Spain
Casany, R:
Hosp Lluis Alcanyis, Carretera Xativa Silla,km 2, Xativa 46800, Spain
Cuatrecasas, G:
Ctr Med Teknon, Carrer Vilana 12, Barcelona 08022, Spain
Fajardo, C:
Hosp Univ La Ribera, Carretera Corbera,Km 1, Valencia 46600, Spain
Galvez, MA:
Hosp Univ Reina Sofia, Avda Menendez Pidal S-N, Cordoba 14004, Spain
Maraver, S:
Hosp Clin Univ Virgen de la Victoria, Campus Univ Teatinos S-N, Malaga 29010, Spain
Martin, T:
Hosp Univ Virgen Macarena, Avd Dr Fedriani 3, Seville 41007, Spain
Romero, E:
Hosp Clin Univ, Ave Ramon & Cajal 3, Valladolid 47005, Spain
Paja, M:
Hosp Univ Basurto, Avda Montevideo 18,Carretera N-634), Bilbao 48013, Spain
Pico, A:
Hosp Gen Univ Alicante, Ave Pintor Baeza 12, Alicante 03010, Spain
Bernabeu, I:
Hosp Clin Univ, Travesia Choupana S-N, Santiago De Compostela 15706, Spain
Resmini, E:
Hosp Santa Creu & Sant Pau, Endocrinol, Pare Claret 167, Barcelona, Spain
Open Access
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