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

Jung-Sievers, Caroline; Baur, Dorothee M.; Schwanke, Anja; Buchfelder, Michael; Droste, Michael; Mann, Klaus; Stalla, Günter K.

doi:10.1007/s11102-015-0673-2

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

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Jung-Sievers, Caroline
RG Clinical Neuroendocrinology, Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

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Stalla, Günter K.
RG Clinical Neuroendocrinology, Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

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引用

Jung-Sievers, C., Baur, D. M., Schwanke, A., Buchfelder, M., Droste, M., Mann, K., & Stalla, G. K. (2015). Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort. PITUITARY, 18(6), 916-923. doi:10.1007/s11102-015-0673-2.

引用: https://hdl.handle.net/11858/00-001M-0000-0029-694D-7

要旨

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 +/- A 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/m(2). 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.