Use of lanreotide in combination with cabergoline or pegvisomant in patients with acromegaly in the clinical practiceThe ACROCOMB study

  1. Manuel Puig Domingo 17
  2. Alfonso Manuel Soto Moreno 1
  3. Eva Venegas Moreno 1
  4. Ricardo Vílchez Joya 2
  5. Concepción Blanco Carrera 3
  6. Fernando Cordido Carballido 4
  7. Tomás Lucas Morante 5
  8. Mónica Marazuela Azpiroz 6
  9. Rosa María Casañ Fernández 7
  10. Guillem Cuatrecasas Cambra 8
  11. Carmen Fajardo Montañana 9
  12. María Angeles Gálvez Moreno 10
  13. Silvia Maraver Selfa 11
  14. Tomás Martín Hernández 18
  15. Enrique Romero Bobillo 12
  16. Miguel Paja Fano 13
  17. Antonio Miguel Picó Alfonso 14
  18. Ignacio Bernabeu Morón 15
  19. Eugenia Resmini 16
  1. 1 Hospital Universitario Virgen del Rocío
    info

    Hospital Universitario Virgen del Rocío

    Sevilla, España

    ROR https://ror.org/04vfhnm78

  2. 2 Hospital Universitario Virgen de las Nieves
    info

    Hospital Universitario Virgen de las Nieves

    Granada, España

    ROR https://ror.org/02f01mz90

  3. 3 Hospital Universitario Príncipe de Asturias
    info

    Hospital Universitario Príncipe de Asturias

    Alcalá de Henares, España

    ROR https://ror.org/01az6dv73

  4. 4 Hospital Universitario de A Coruña
  5. 5 Hospital Universitario Puerta de Hierro
    info

    Hospital Universitario Puerta de Hierro

    Madrid, España

    ROR https://ror.org/01e57nb43

  6. 6 Hospital Universitario de la Princesa
    info

    Hospital Universitario de la Princesa

    Madrid, España

    ROR https://ror.org/03cg5md32

  7. 7 Hospital Xàtiva Lluis Alcanyis
    info

    Hospital Xàtiva Lluis Alcanyis

    Játiva, España

    ROR https://ror.org/03yk4dt83

  8. 8 Centro Medico Teknon
    info

    Centro Medico Teknon

    Barcelona, España

    ROR https://ror.org/00fsrkw38

  9. 9 Hospital Universitario de La Ribera
  10. 10 Hospital Universitario Reina Sofia
    info

    Hospital Universitario Reina Sofia

    Córdoba, España

    ROR https://ror.org/02vtd2q19

  11. 11 Hospital Universitario Virgen de la Victoria
    info

    Hospital Universitario Virgen de la Victoria

    Málaga, España

    ROR https://ror.org/05xxs2z38

  12. 12 Hospital Universitario de Valladolid
    info

    Hospital Universitario de Valladolid

    Valladolid, España

    ROR https://ror.org/04fffmj41

  13. 13 Hospital Universitario de Basurto
    info

    Hospital Universitario de Basurto

    Bilbao, España

    ROR https://ror.org/00j4pze04

  14. 14 Hospital General Universitari d´Alacant
  15. 15 Complexo Hospitalario Universitario de Santiago
    info

    Complexo Hospitalario Universitario de Santiago

    Santiago de Compostela, España

    ROR https://ror.org/00mpdg388

  16. 16 Hospital de la Santa Creu i Sant Pau
    info

    Hospital de la Santa Creu i Sant Pau

    Barcelona, España

    ROR https://ror.org/059n1d175

  17. 17 Hospital Germans Trias i Pujol
  18. 18 Hospital Universitario Virgen Macarena
    info

    Hospital Universitario Virgen Macarena

    Sevilla, España

    ROR https://ror.org/016p83279

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Journal:
Endocrinología y nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición

ISSN: 1575-0922

Year of publication: 2016

Volume: 63

Issue: 8

Pages: 397-408

Type: Article

DOI: 10.1016/J.ENDONU.2016.05.010 DIALNET GOOGLE SCHOLAR

More publications in: Endocrinología y nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición

Abstract

Purpose To describe real-world use of lanreotide combination therapy for acromegaly. Patients and methods ACROCOMB is a retrospective observational Spanish study of patients with active acromegaly treated with lanreotide combination therapy between 2006 and 2011. 108 patients treated at 44 Spanish Endocrinology Departments were analyzed separately: 61 patients received lanreotide/cabergoline (cabergoline cohort) and 47 lanreotide/pegvisomant (pegvisomant cohort). Results Patient median age was 50.8 years in the cabergoline cohort and 42.7 years in the pegvisomant cohort. Prior medical treatments were somatostatin analogue (SSA) monotherapy (40 [66%] patients) or dopamine agonists (7 [11%] patients) in the cabergoline cohort and SSA (29 [62%] patients) or pegvisomant monotherapy (16 [34%] patients) in the pegvisomant cohort. Across both cohorts 12 patients were previously untreated, and prior therapy was unknown/missing in 4 patients. Median duration of combined treatment was 1.6 years (0.1–6) and 2.1 years (0.4–6.3) in the cabergoline and pegvisomant cohorts, respectively. At baseline, median insulin growth factor (IGF)-I values were 149% upper limit of normal (ULN) (15–505%) in the cabergoline cohort and 156% ULN (15–534%) in the pegvisomant cohort, and decreased to 104% ULN (13–557%) p < 0.001 and 86% ULN (23–345%) p < 0.0001, respectively, at end of study (EOS). Normal age-adjusted values of IGF-I were obtained in 48% of lanreotide/cabergoline-treated patients and 70% of lanreotide/pegvisomant-treated patients at EOS. There were no significant changes in hepatic, cardiac or glycaemic parameters in either cohort. Conclusion In clinical practice lanreotide treatment combinations are useful options for patients with acromegaly when monotherapy is insufficient; particularly, the combination of lanreotide and pegvisomant in patients not controlled with either SSA or pegvisomant alone has high efficacy and is well-tolerated.

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Funding information

No conflict of interest: RV, CB, RC, CF, SM, TM, TL, MM. Conflicts of interest include: • Employment and consultancies: MP-D: consultancies from Pfizer. • Grants, fees and honoraria: MP-D has received lecture honoraria from Novartis, Pfizer and Ipsen; FC: has received lecture honoraria from Novartis and Pfizer and unrestricted research grants from Ipsen Pharma; MP: speaker fees from Ipsen and Pfizer; AS: Clinical trials and donations for investigator-initiated research projects by Ipsen, Novartis and Pfizer; AP: advisory board Pfizer; IB: Advisory fees: Pfizer; research grants: Pfizer; lectures fees: Pfizer, Novartis. • Board membership: MP-D: Pfizer.

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Data source: Dialnet