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Pituitary

, Volume 18, Issue 6, pp 916–923 | Cite as

Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort

  • Caroline SieversEmail author
  • Dorothee M. Baur
  • Anja Schwanke
  • Michael Buchfelder
  • Michael Droste
  • Klaus Mann
  • Günter K. Stalla
Article

Abstract

Purpose

This study aimed at investigating predicting factors for therapy response under growth hormone receptor antagonist therapy with a focus on subjective and patient-oriented measures.

Methods

Observational, multicenter nested-cohort study including 271 selected patients with the diagnosis of acromegaly and a minimum of one-year follow-up period within the German ACROSTUDY cohort (total cohort: n = 514). Outcome measures were the change of the biomarker IGF-1 (IGF-1 change and IGF-1 normalisation) between baseline and after 1 year of pegvisomant therapy (12 ± 6 months). Main predictors were patient-assessed subjective measures according to the Patient-Assessed Acromegaly Symptom Questionnaire (PASQ) in conjugation with age, gender, BMI, max. dosage of pegvisomant at follow-up and IGF-1 before the start of pegvisomant therapy.

Results

The mean age of the study population was 51.2 (13.9) years and the mean BMI was 29.5 (5.1) kg/m2. In adjusted analyses, none of the individual perceived health (PASQ) scores, but age, BMI and IGF-1 at baseline were predictive for an IGF-1 decrease after 1 year of pegvisomant therapy and BMI and IGF-1, but equally none of the PASQ items, were predicting IGF-1 normalisation.

Conclusions

Age, BMI and baseline IGF-1 but not subjective perceived health measures predict therapy response under second line medical therapy with pegvisomant.

Keywords

Acromegaly Health-related quality of life Pegvisomant Growth hormone IGF-1 

Notes

Acknowledgments

We gratefully acknowledge the excellent support and critical discussion of the ACROSTUDY board members. Moreover, the authors thank all the investigators and study nurses of the individual centres for contributing data to the ACROSTUDY. ACROSTUDY is sponsored by Pfizer Inc.

Compliance with ethical standards

Conflict of interset

M. D., M. B., K. M., and G. K. S. are members of the Scientific ACROSTUDY German Board, which is sponsored by Pfizer GmbH, Germany. C. S. has received consultant fees as a member of ACROSTUDY Steering Committee. A. S. is currently employed by Pfizer GmbH Germany. K. M. is a member of the HNR board, which is funded by the Heinz Nixdorf Stiftung, Essen. C. S., M. B., K. M. and G. K. S. received German Pfizer Grants for other projects as well as lecture fees from Pfizer. D. M. B. has nothing to declare.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Caroline Sievers
    • 1
    Email author
  • Dorothee M. Baur
    • 2
  • Anja Schwanke
    • 3
  • Michael Buchfelder
    • 4
  • Michael Droste
    • 5
  • Klaus Mann
    • 6
  • Günter K. Stalla
    • 1
  1. 1.Clinical Neuroendocrinology, Clinical Research DepartmentMax Planck Institute of PsychiatryMunichGermany
  2. 2.II Medizinische Klinik und PoliklinikKlinikum rechts der IsarMunichGermany
  3. 3.Endocrine CarePfizer Pharma GmbHBerlinGermany
  4. 4.Department of NeurosurgeryUniversity of Erlangen-NurembergErlangenGermany
  5. 5.Endokrinologische PraxisOldenburgGermany
  6. 6.Department of Endocrinology and MetabolismUniversity of Duisburg-Essen and EndokrinologiezentrumAlter Hof, MunichGermany

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