Long-term remission of acromegaly after somatostatin analogues withdrawal: a single-centre experience.
J Endocrinol Invest
; 44(12): 2593-2599, 2021 Dec.
Article
in En
| MEDLINE
| ID: mdl-34018167
ABSTRACT
PURPOSE:
A long-lasting remission of acromegaly after somatostatin analogues (SAs) withdrawal has been described in some series. Our aim was to update the disease evolution after SAs withdrawal in a cohort of acromegalic patients.METHODS:
We retrospectively evaluated 21 acromegalic patients previously included in a multicentre study (Ronchi et al. 2008), updating data at the last follow-up. We added further 8 patients selected for SAs withdrawal between 2008-2018. Pituitary irradiation represented an exclusion criterion. The withdrawal was suggested after at least 9 months of clinical and hormonal disease control. Clinical and biochemical data prior and after SAs withdrawal were analysed.RESULTS:
In the whole cohort (29 patients) mean age was 50 ± 14.9 years and 72.4% were females. In 69% pituitary surgery was previously performed. Overall, the median time of treatment before SAs withdrawal was 53 months (IQR = 24-84). At the last follow up in 2019, 23/29 patients (79.3%) had a disease relapse after a median time of 6 months (interquartile range or IQR = 3-12) from the drug suspension, while 6/29 (20.7%) were still on remission after 120 months (IQR = 66-150). IGF-1 levels were significantly lower before withdrawal in patients with persistent remission compared to relapsing ones (IGF-1 SDS -1.5 ± 0.6 vs -0.11 ± 1, p = 0.01). We did not observe any other difference between patients with and without relapse, including SAs formulation, dosage and treatment duration.CONCLUSION:
A successful withdrawal of SAs is possible in a subset of well-controlled acromegalic patients and it challenges the concept that medical therapy is a lifelong requirement.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acromegaly
/
Insulin-Like Growth Factor I
/
Somatostatin
/
Withholding Treatment
/
Secondary Prevention
Type of study:
Diagnostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Endocrinol Invest
Year:
2021
Type:
Article
Affiliation country:
Italy