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Long-term safety and efficacy of long-acting pasireotide in acromegaly

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Abstract

Background

Pasireotide long acting (LAR) can be effective in normalizing insulin-like growth factor (IGF)-1 level in acromegaly patients inadequately controlled by octreotide or lanreotide.

Objective

Determine the long-term efficacy and safety of pasireotide, including time to biochemical control and time to best response, and risk for diabetes mellitus.

Methods

A retrospective multicenter study investigating the efficacy and safety of pasireotide LAR treatment in patients with active acromegaly treated for >12 months.

Results

The study included 19 patients (10 men; mean age ± SD, 48.0 ± 12.9 years) treated with pasireotide for a mean of 50 ± 36 months. During the follow-up, 4 patients discontinued pasireotide treatment. Pasireotide LAR produced a tolerable and long-term significant biochemical response in 15 of 19 patients (79.0%). Mean time to IGF-1 normalization from pasireotide LAR initiation was 13.6 ± 16.9 months with early biochemical normalization (<12 months) evident in 11 (64.7%) patients and delayed IGF-1 normalization in 6 (35.2%) patients. Nadir IGF-1 values were recorded within the first 12 months in 6 patients (35.3%), while in 11 patients (64.7%) lowest values were reported after >12 months of treatment, including 4 of 11 patients with early IGF-1 normalization. New-onset diabetes was documented in 5 of 7 patients with pre-diabetes and in 1 of 5 patients with normal glucose homeostasis at baseline. Among patients with pre-diabetes or diabetes mellitus prior to initiating pasireotide, mean HbA1c increase was 0.56 ± 1.0%.

Conclusions

The results support the long-term efficacy and safety of pasireotide LAR for acromegaly and support the potential delayed effect of treatment on IGF-1 normalization.

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Acknowledgements

A.A. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Institute of Endocrinology, Beilinson Hospital, Petach Tikva, Israel

    Amit Akirov, Alexander Gorshtein, Idit Dotan & Ilan Shimon

  2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Amit Akirov, Alexander Gorshtein, Idit Dotan & Ilan Shimon

  3. Linn Medical Center, Clalit Medical Services, Haifa, Israel

    Nariman Saba Khazen, Yulia Pauker & Michal Gershinsky

Authors
  1. Amit Akirov
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  2. Alexander Gorshtein
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  3. Idit Dotan
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  4. Nariman Saba Khazen
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  5. Yulia Pauker
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  6. Michal Gershinsky
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  7. Ilan Shimon
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Correspondence to Amit Akirov.

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Akirov, A., Gorshtein, A., Dotan, I. et al. Long-term safety and efficacy of long-acting pasireotide in acromegaly. Endocrine 74, 396–403 (2021). https://doi.org/10.1007/s12020-021-02782-2

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  • DOI: https://doi.org/10.1007/s12020-021-02782-2

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