Somapacitan-induced reversible lipoatrophy in an adult woman with hypopituitarism.

IF 3.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pituitary Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI:10.1007/s11102-024-01440-w

Matej Rakusa, Andrej Janez, Mojca Jensterle

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引用次数: 0

Abstract

Background: Lipoatrophy is rare adverse event (AE) in daily recombinant human growth hormone (rhGH). Data on lipoatrophy in newly developed long-acting GH (LAGH) are scarce. We report the first case of lipoatrophy in adult patient treated with LAGH somapacitan.

Case presentation: A 38-year-old woman with congenital panhypopituitarism was transitioned from daily rhGH 0.4 mg QD to somapacitan dose 4 mg QW due to non-adherence to daily rhGH. Despite adequate education and regular changing of injection sites, the patient reported reduced subcutaneous tissue at all four injection sites, after the 4th application of somapacitan. Somapacitan was discontinued at patient preference and lipoatrophy completely reversed after 3 months.

Conclusions: Lipoatrophy caused by somapacitan was completely reversible. We speculate that high initial dose and volume of somapacitan caused delayed diffusion and a direct local lipolytic effect in our patient. Although, titration of somapacitan was initiated as previously reported in REAL2 study protocol, recent clinical guidelines advise more gradual increase of somapacitan dose also in women on oral estogens that are switched from daily rhGH. Importantly, our case and the two previously described cases in children in the REAL 3 study showed that lipoatrophy caused by somapacitan was transient and completely reversible, and that discontinuation of the drug is not always mandatory.

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一名患有垂体功能减退症的成年女性因索马普坦引起的可逆性脂肪变性。

背景脂肪萎缩是每日使用重组人生长激素（rhGH）的罕见不良反应（AE）。有关新开发的长效生长激素（LAGH）脂肪变性的数据很少。我们报告了首例接受长效生长激素索马帕西坦治疗的成年患者的脂肪萎缩病例：一名患有先天性泛垂体功能障碍的 38 岁女性患者，由于不能坚持每天使用 rhGH，从每天 0.4 毫克 QD 的剂量过渡到 4 毫克 QW 的 somapacitan 剂量。尽管对患者进行了充分教育，并定期更换注射部位，但在第 4 次使用索马帕西坦后，患者报告说四个注射部位的皮下组织均有所减少。根据患者的意愿停用索马帕吉坦，3个月后脂肪萎缩完全逆转：结论：索马帕奇坦引起的脂肪萎缩是完全可逆的。结论：索马帕昔坦引起的脂肪萎缩是完全可逆的。我们推测，索马帕昔坦的初始剂量和用量过高，导致扩散延迟，对患者产生了直接的局部溶脂作用。虽然索马帕坦的滴定是按照之前的 REAL2 研究方案进行的，但最近的临床指南建议，对于使用口服雌激素的妇女，从每日使用 rhGH 转为使用索马帕坦时，也应循序渐进地增加索马帕坦的剂量。重要的是，我们的病例和之前在 REAL 3 研究中描述的两例儿童病例表明，索马帕坦引起的脂肪变性是短暂的，完全可逆，停药并不总是强制性的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.