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The effects of pre-operative somatostatin analogue therapy on treatment cost and remission in acromegaly

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Abstract

Purpose

To investigate the effects of preoperative somatostatin analogue (SSA) treatment on the annual cost of all acromegaly treatment modalities and on remission rates.

Methods

The medical records of 135 patients with acromegaly who were followed at endocrinology clinic of Cerrahpasa Medical Faculty for at least 2 years after surgery between 2009 and 2016 were reviewed.

Results

The mean follow-up time was 50.9 ± 25.7 months. Early remission was defined according to 3rd month values in patients who didn’t achieve remission, and 6th month values in patients who achieved remission at the 3rd month after surgery. The early and late remission rates of the entire study population were 40% and 80.7%, respectively. The early remission of the preoperative SSA-treated group (61.5%) was significantly higher than SSA-untreated group (31.2%) (p = 0.002). The early remission of the preoperative SSA-treated patients with macroadenomas (52.2%) was also significantly higher than the SSA-untreated group (23.5%) (p = 0.02). In the subgroup analysis; this difference was much more pronounced in invasive macroadenomas (p = 0.002). There were no differences between the groups in terms of late remission.The median annual cost of all acromegaly treatment modalities in study population was €3788.4; the cost for macroadenomas was significantly higher than for microadenomas (€4125.0 vs. €3226.5, respectively; p = 0.03). Preoperative SSA use in both microadenomas and macroadenomas didn’t alter the cost of treatment. The increase in the duration of preoperative medical treatment had no effect on early or late remissions (p = 0.09; p = 0.8).

Conclusions

Preoperative medical treatment had no effect on the costs of acromegaly treatment. There was a benefical effect of pre-operative SSA use on early remission in patients with macroadenomas; however, this effect didn’t persist long term.

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Acknowledgments

This research did not receive any specific grant from any funding agencies in the public, commercial, or non-profit sector. We would like to thank David Chapman for his help with the proofreading this manuscript.

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Authors and Affiliations

  1. Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey

    Ozge Polat Korkmaz, Ozlem Haliloglu, Hande Mefkure Ozkaya, Serdar Sahin & Pinar Kadioglu

  2. Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Mert Gurcan

  3. Department of Internal Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey

    Fatma Eda Nuhoglu Kantarci

  4. Department of Public Health, Istanbul University, Istanbul, Turkey

    Meryem Merve Oren

  5. Department of Neurosurgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Necmettin Tanriover & Nurperi Gazioglu

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  1. Ozge Polat Korkmaz
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Correspondence to Pinar Kadioglu.

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The study was approved by the local ethics committee of Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty and all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Polat Korkmaz, O., Gurcan, M., Nuhoglu Kantarci, F.E. et al. The effects of pre-operative somatostatin analogue therapy on treatment cost and remission in acromegaly. Pituitary 22, 387–396 (2019). https://doi.org/10.1007/s11102-019-00968-6

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