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Title: Brazilian multicenter study on pegvisomant treatment in acromegaly
Authors: Boguszewski, Cesar L.
Huayllas, Martha Katherine P
Vilar, Lucio
Naves, Luciana Ansaneli
Ribeiro-Oliveira Junior, Antonio
Soares, Beatriz Santana
Czepielewski, Mauro Antonio
Abucham, Julio
Correa-Silva, Silvia Regina
Bronstein, Marcello Delano
Jallad, Raquel Soares
Duarte, Felipe Gaia
Musolino, Nina Rosa
Kasuki, Leandro
Gadelha, Monica Roberto
Assunto:: Acromegalia
Estudo multicêntrico
Issue Date: 2019
Publisher: Sociedade Brasileira de Endocrinologia e Metabologia
Citation: BOGUSZEWSKI, Cesar L. et al. Brazilian multicenter study on pegvisomant treatment in acromegaly. Archives of Endocrinology and Metabolism, v. 63, n. 4, p. 328-336, 2019. DOI: Disponível em: Acesso em: 23 jan. 2020.
Abstract: Objective Investigate the therapeutic response of acromegaly patients to pegvisomant (PEGV) in a real-life, Brazilian multicenter study. Subjects and methods Characteristics of acromegaly patients treated with PEGV were reviewed at diagnosis, just before and during treatment. All patients with at least two IGF-I measurements on PEGV were included. Efficacy was defined as any normal IGF-I measurement during treatment. Safety data were reviewed. Predictors of response were determined by comparing controlled versus uncontrolled patients. Results 109 patients [61 women; median age at diagnosis 34 years; 95.3% macroadenomas] from 10 Brazilian centers were studied. Previous treatment included surgery (89%), radiotherapy (34%), somatostatin receptor ligands (99%), and cabergoline (67%). Before PEGV, median levels of GH, IGF-I and IGF-I % of upper limit of normal were 4.3 µg/L, 613 ng/mL, and 209%, respectively. Pre-diabetes/diabetes was present in 48.6% and tumor remnant in 71% of patients. Initial dose was 10 mg/day in all except 4 cases, maximum dose was 30 mg/day, and median exposure time was 30.5 months. PEGV was used as monotherapy in 11% of cases. Normal IGF-I levels was obtained in 74.1% of patients. Glycemic control improved in 56.6% of patients with pre-diabetes/diabetes. Exposure time, pre-treatment GH and IGF-I levels were predictors of response. Tumor enlargement occurred in 6.5% and elevation of liver enzymes in 9.2%. PEGV was discontinued in 6 patients and 3 deaths unrelated to the drug were reported. Conclusions In a real-life scenario, PEGV is a highly effective and safe treatment for acromegaly patients not controlled with other therapies.
Licença:: (CC BY) - This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Appears in Collections:FMD - Artigos publicados em periódicos e preprints

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