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Multivariable Prediction Model for Biochemical Response to First-Generation Somatostatin Receptor Ligands in Acromegaly

Data de publicação:

Autores da FMUP

  • Davide Maurício Costa Carvalho

    Autor

Participantes de fora da FMUP

  • Coopmans, EC
  • Korevaar, TIM
  • van Meyel, SWF
  • Daly, AF
  • Chanson, P
  • Brue, T
  • Delemer, B
  • Hana, V
  • Colao, A
  • Jaffrain Rea, ML
  • Stalla, GK
  • Fajardo Montanana, C
  • Beckers, A
  • van der Lely, AJ
  • Petrossians, P
  • Neggers, SJCMM

Unidades de investigação

Abstract

Context: First-generation somatostatin receptor ligands (fg-SRLs) represent the mainstay of medical therapy for acromegaly, but they provide biochemical control of disease in only a subset of patients. Various pretreatment biomarkers might affect biochemical response to fg-SRLs. Objective: To identify clinical predictors of the biochemical response to fg-SRLs monotherapy defined as biochemical response (insulin-like growth factor (IGF)-1 <= 1.3 x ULN (upper limit of normal)), partial response (>20% relative IGF-1 reduction without normalization), and nonresponse (<= 20% relative IGF-1 reduction), and IGF-1 reduction. Design: Retrospective multicenter study. Setting: Eight participating European centers. Methods: We performed a meta-analysis of participant data from 2 cohorts (Rotterdam and Liege acromegaly survey, 622 out of 3520 patients). Multivariable regression models were used to identify predictors of biochemical response to fg-SRL monotherapy. Results: Lower IGF-1 concentration at baseline (odds ratio (OR) = 0.82, 95% confidence interval (CI) 0.72-0.95 IGF-1 ULN, P = .0073) and lower bodyweight (OR = 0.99, 95% CI 0.98-0.99 kg, P = .038) were associated with biochemical response. Higher IGF-1 concentration at baseline (OR = 1.40, (1.19-1.65) IGF-1 ULN, P <= .0001), the presence of type 2 diabetes (oral medication OR = 2.48, (1.43-4.29), P = .0013; insulin therapy OR = 2.65, (1.02-6.70), P = .045), and higher bodyweight (OR = 1.02, (1.01-1.04) kg, P = .0023) were associated with achieving partial response. Younger patients at diagnosis are more likely to achieve nonresponse (OR = 0.96, (0.94-0.99) year, P = .0070). Baseline IGF-1 and growth hormone concentration at diagnosis were associated with absolute IGF-1 reduction (beta = 0.90, standard error (SE) = 0.02, P <= .0001 and beta = 0.002, SE = 0.001, P = .014, respectively). Conclusion: Baseline IGF-1 concentration was the best predictor of biochemical response to fg-SRL, followed by bodyweight, while younger patients were more likely to achieve nonresponse.

Dados da publicação

ISSN/ISSNe:
0021-972X, 1945-7197

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM  Endocrine Society

Tipo:
Article
Páginas:
2964-2974
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 17

Citações Recebidas na Scopus: 28

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Keywords

  • acromegaly; first-generation somatostatin receptor ligands; biochemical response

Campos de estudo

Financiamento

Ipsen

Proyectos asociados

Diabetic Neuropathy, Central Nervous System Plasticity and Metabolic Disfunction

Investigador Principal: Davide Maurício Costa Carvalho

Estudo Clínico Académico . 2020

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