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http://hdl.handle.net/2183/41410 Effectiveness of combined first-line medical treatment in acromegaly with prolactin cosecretion
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Biagetti, Betina
Araújo-Castro, Marta
Menéndez-Torre, Edelmiro Luis
Novoa-Testa, Iria
Pascual-Corrales, Eider
Rodríguez-Berrocal, Víctor
Guerrero-Pérez, Fernando
Vicente, Almudena
Percovich, Juan Carlos
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Bibliographic citation
Biagetti B, Araujo-Castro M, Torre EM, Novoa-Testa I, Cordido F, Corrales EP, Berrocal VR, Guerrero-Pérez F, Vicente A, Percovich JC, Centeno RG, González L, García MDO, Echarri AI, Rodríguez MDM, Novo-Rodríguez C, Calatayud M, Villar-Taibo R, Bernabéu I, Alvarez-Escola C, Valderrama PB, Tenorio-Jiménez C, Galiana PA, Moreno EV, Molero IG, Iglesias P, Blanco C, De Lara FV, de Miguel P, Mezquita EL, Hanzu F, Aldecoa I, Aznar S, Lamas C, Aulinas A, Asla Roca Q, Gracia P, Córdova JMR, Aviles M, Asensio-Wandosel D, Sampedro M, Cámara R, Paja M, Ruz-Caracuel I, Fajardo-Montañana C, Asanza EC, Martinez-Saez E, Marazuela M, Puig-Domingo M. Effectiveness of combined first-line medical treatment in acromegaly with prolactin cosecretion. Eur J Endocrinol. 2024 Jun 5;190(6):458-466.
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Abstract
[Abstract]
Objective: The aim of this study is to compare the response to first-line medical treatment in treatment-naive acromegaly patients with pure growth hormone (GH)-secreting pituitary adenoma (GH-PA) and those with GH and prolactin cosecreting PA (GH&PRL-PA).
Design: This is a retrospective multicentric study of acromegaly patients followed from 2003 to 2023 in 33 tertiary Spanish hospitals with at least 6 months of first-line medical treatment.
Methods: Baseline characteristics, first-line medical treatment strategies, and outcomes were analyzed. We employed a multiple logistic regression full model to estimate the impact of some baseline characteristics on disease control after each treatment modality.
Results: Of the 144 patients included, 72.9% had a GH-PA, and 27.1% had a GH&PRL-PA. Patients with GH&PRL-PA were younger (43.9 ± 15.0 vs 51.9 ± 12.7 years, P < .01) and harboring more frequently macroadenomas (89.7% vs 72.1%, P = .03). First-generation somatostatin receptor ligand (fgSRL) as monotherapy was given to 106 (73.6%) and a combination treatment with fgSRL and cabergoline in the remaining 38 (26.4%). Patients with GH&PRL-PA received more frequently a combination therapy (56.4% vs 15.2%, P < .01). After 6 months of treatment, in the group of patients under fgSRL as monotherapy, those patients with GH&PRL-PA had worse control compared to GH-PAs (29.4% vs 55.1%, P = .04). However, these differences in the rate of disease control between both groups disappeared when both received combination treatment with fgSRL and cabergoline.
Conclusion: In GH&PRL-PA, the biochemical control achieved with fgSRL as monotherapy is substantially worse than in patients harboring GH-PA, supporting the inclusion of cabergoline as first-line medical treatment in combination with fgSRLs in these subgroups of patients.
Description
Multicenter study
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This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Endocrinology following peer review. The version of record is available online at Oxford Academic web page.