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Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study
CONTEXT: The effect of pegvisomant on IGF1 levels in patients with acromegaly is well documented, but little is known of its long-term impact on comorbidity. AIM: The aim of this retrospective study was to evaluate the effects of long-term pegvisomant therapy on cardiorespiratory and metabolic comor...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bioscientifica Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592912/ https://www.ncbi.nlm.nih.gov/pubmed/26429918 http://dx.doi.org/10.1530/EJE-15-0500 |
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author | Kuhn, Emmanuelle Maione, Luigi Bouchachi, Amir Rozière, Myriam Salenave, Sylvie Brailly-Tabard, Sylvie Young, Jacques Kamenicky, Peter Assayag, Patrick Chanson, Philippe |
author_facet | Kuhn, Emmanuelle Maione, Luigi Bouchachi, Amir Rozière, Myriam Salenave, Sylvie Brailly-Tabard, Sylvie Young, Jacques Kamenicky, Peter Assayag, Patrick Chanson, Philippe |
author_sort | Kuhn, Emmanuelle |
collection | PubMed |
description | CONTEXT: The effect of pegvisomant on IGF1 levels in patients with acromegaly is well documented, but little is known of its long-term impact on comorbidity. AIM: The aim of this retrospective study was to evaluate the effects of long-term pegvisomant therapy on cardiorespiratory and metabolic comorbidity in patients with acromegaly. PATIENTS AND METHODS: We analyzed the long-term (up to 10 years) effect of pegvisomant therapy given alone (n=19, 45%) or in addition to somatostatin analogues and/or cabergoline (n=23, 55%) on echocardiographic, polysomnographic and metabolic parameters in respectively 42, 12 and 26 patients with acromegaly followed in Bicêtre hospital. RESULTS: At the first cardiac evaluation, 20±16 months after pegvisomant introduction, IGF1 levels normalized in 29 (69%) of the 42 patients. The left ventricular ejection fraction (LVEF) improved significantly in patients whose basal LVEF was ≤60% and decreased in those whose LVEF was >70%. The left ventricular mass index (LVMi) decreased from 123±25 to 101±21 g/m(2) (P<0.05) in the 17 patients with a basal LVMi higher than the median (91 g/m(2)), while it remained stable in the other patients. Pegvisomant reduced the apnoea–hypopnea index and cured obstructive sleep apnea (OSA) in four of the eight patients concerned. Long-term follow-up of 22 patients showed continuing improvements in cardiac parameters. The BMI and LDL cholesterol level increased minimally during pegvisomant therapy, and other lipid parameters were not modified. CONCLUSIONS: Long-term pegvisomant therapy not only normalizes IGF1 in a large proportion of patients but also improves cardiac and respiratory comorbidity. |
format | Online Article Text |
id | pubmed-4592912 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-45929122015-11-01 Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study Kuhn, Emmanuelle Maione, Luigi Bouchachi, Amir Rozière, Myriam Salenave, Sylvie Brailly-Tabard, Sylvie Young, Jacques Kamenicky, Peter Assayag, Patrick Chanson, Philippe Eur J Endocrinol Clinical Study CONTEXT: The effect of pegvisomant on IGF1 levels in patients with acromegaly is well documented, but little is known of its long-term impact on comorbidity. AIM: The aim of this retrospective study was to evaluate the effects of long-term pegvisomant therapy on cardiorespiratory and metabolic comorbidity in patients with acromegaly. PATIENTS AND METHODS: We analyzed the long-term (up to 10 years) effect of pegvisomant therapy given alone (n=19, 45%) or in addition to somatostatin analogues and/or cabergoline (n=23, 55%) on echocardiographic, polysomnographic and metabolic parameters in respectively 42, 12 and 26 patients with acromegaly followed in Bicêtre hospital. RESULTS: At the first cardiac evaluation, 20±16 months after pegvisomant introduction, IGF1 levels normalized in 29 (69%) of the 42 patients. The left ventricular ejection fraction (LVEF) improved significantly in patients whose basal LVEF was ≤60% and decreased in those whose LVEF was >70%. The left ventricular mass index (LVMi) decreased from 123±25 to 101±21 g/m(2) (P<0.05) in the 17 patients with a basal LVMi higher than the median (91 g/m(2)), while it remained stable in the other patients. Pegvisomant reduced the apnoea–hypopnea index and cured obstructive sleep apnea (OSA) in four of the eight patients concerned. Long-term follow-up of 22 patients showed continuing improvements in cardiac parameters. The BMI and LDL cholesterol level increased minimally during pegvisomant therapy, and other lipid parameters were not modified. CONCLUSIONS: Long-term pegvisomant therapy not only normalizes IGF1 in a large proportion of patients but also improves cardiac and respiratory comorbidity. Bioscientifica Ltd 2015-11 /pmc/articles/PMC4592912/ /pubmed/26429918 http://dx.doi.org/10.1530/EJE-15-0500 Text en © 2015 The authors http://creativecommons.org/licenses/by/3.0/deed.en_GB This work is licensed under a Creative Commons Attribution 3.0 Unported License (http://creativecommons.org/licenses/by/3.0/deed.en_GB) |
spellingShingle | Clinical Study Kuhn, Emmanuelle Maione, Luigi Bouchachi, Amir Rozière, Myriam Salenave, Sylvie Brailly-Tabard, Sylvie Young, Jacques Kamenicky, Peter Assayag, Patrick Chanson, Philippe Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
title | Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
title_full | Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
title_fullStr | Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
title_full_unstemmed | Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
title_short | Long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
title_sort | long-term effects of pegvisomant on comorbidities in patients with acromegaly: a retrospective single-center study |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592912/ https://www.ncbi.nlm.nih.gov/pubmed/26429918 http://dx.doi.org/10.1530/EJE-15-0500 |
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