Betina Biagetti, Marta Araujo-Castro, Edelmiro Menéndez Torre, Iría Novoa-Testa, Fernando Cordido, Eider Pascual Corrales, Víctor Rodríguez Berrocal, Fernando Guerrero-Pérez, Almudena Vicente, Juan Carlos Percovich, Rogelio García Centeno, Laura González, María Dolores Ollero García, Ana Irigaray Echarri, María Dolores Moure Rodríguez, Cristina Novo-Rodríguez, María Calatayud, Rocío Villar-Taibo, Ignacio Bernabéu, Cristina Alvarez-Escola, Pamela Benítez Valderrama, Carmen Tenorio-Jiménez, Pablo Abellán Galiana, Eva Venegas Moreno, Inmaculada González Molero, Pedro Iglesias, Concepción Blanco, Fernando Vidal-Ostos De Lara, Paz de Miguel, Elena López Mezquita, Felicia Hanzu, Iban Aldecoa, Silvia Aznar, Cristina Lamas, Anna Aulinas, Queralt Asla Roca, Paola Gracia, José María Recio Córdova, Mariola Aviles, Diego Asensio-Wandosel, Miguel Sampedro, Rosa Cámara, Miguel Paja, Ignacio Ruz-Caracuel, Carmen Fajardo-Montañana, Esteban Cordero Asanza, Elena Martinez-Saez, Mónica Marazuela, Manel Puig-Domingo
{"title":"联合一线药物治疗肢端肥大症伴泌乳素共同分泌的疗效。","authors":"Betina Biagetti, Marta Araujo-Castro, Edelmiro Menéndez Torre, Iría Novoa-Testa, Fernando Cordido, Eider Pascual Corrales, Víctor Rodríguez Berrocal, Fernando Guerrero-Pérez, Almudena Vicente, Juan Carlos Percovich, Rogelio García Centeno, Laura González, María Dolores Ollero García, Ana Irigaray Echarri, María Dolores Moure Rodríguez, Cristina Novo-Rodríguez, María Calatayud, Rocío Villar-Taibo, Ignacio Bernabéu, Cristina Alvarez-Escola, Pamela Benítez Valderrama, Carmen Tenorio-Jiménez, Pablo Abellán Galiana, Eva Venegas Moreno, Inmaculada González Molero, Pedro Iglesias, Concepción Blanco, Fernando Vidal-Ostos De Lara, Paz de Miguel, Elena López Mezquita, Felicia Hanzu, Iban Aldecoa, Silvia Aznar, Cristina Lamas, Anna Aulinas, Queralt Asla Roca, Paola Gracia, José María Recio Córdova, Mariola Aviles, Diego Asensio-Wandosel, Miguel Sampedro, Rosa Cámara, Miguel Paja, Ignacio Ruz-Caracuel, Carmen Fajardo-Montañana, Esteban Cordero Asanza, Elena Martinez-Saez, Mónica Marazuela, Manel Puig-Domingo","doi":"10.1093/ejendo/lvae053","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":null,"pages":null},"PeriodicalIF":5.3000,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of combined first-line medical treatment in acromegaly with prolactin cosecretion.\",\"authors\":\"Betina Biagetti, Marta Araujo-Castro, Edelmiro Menéndez Torre, Iría Novoa-Testa, Fernando Cordido, Eider Pascual Corrales, Víctor Rodríguez Berrocal, Fernando Guerrero-Pérez, Almudena Vicente, Juan Carlos Percovich, Rogelio García Centeno, Laura González, María Dolores Ollero García, Ana Irigaray Echarri, María Dolores Moure Rodríguez, Cristina Novo-Rodríguez, María Calatayud, Rocío Villar-Taibo, Ignacio Bernabéu, Cristina Alvarez-Escola, Pamela Benítez Valderrama, Carmen Tenorio-Jiménez, Pablo Abellán Galiana, Eva Venegas Moreno, Inmaculada González Molero, Pedro Iglesias, Concepción Blanco, Fernando Vidal-Ostos De Lara, Paz de Miguel, Elena López Mezquita, Felicia Hanzu, Iban Aldecoa, Silvia Aznar, Cristina Lamas, Anna Aulinas, Queralt Asla Roca, Paola Gracia, José María Recio Córdova, Mariola Aviles, Diego Asensio-Wandosel, Miguel Sampedro, Rosa Cámara, Miguel Paja, Ignacio Ruz-Caracuel, Carmen Fajardo-Montañana, Esteban Cordero Asanza, Elena Martinez-Saez, Mónica Marazuela, Manel Puig-Domingo\",\"doi\":\"10.1093/ejendo/lvae053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":11884,\"journal\":{\"name\":\"European Journal of Endocrinology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2024-06-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Endocrinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ejendo/lvae053\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ejendo/lvae053","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Effectiveness of combined first-line medical treatment in acromegaly with prolactin cosecretion.
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.
期刊介绍:
European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica.
The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology.
Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials.
Equal consideration is given to all manuscripts in English from any country.