التفاصيل البيبلوغرافية
| العنوان: |
Factors associated with therapeutic response in acromegaly diagnosed in the elderly in Spain. |
| المؤلفون: |
Biagetti, Betina, Iglesias, Pedro, Villar-Taibo, Rocío, Moure, María-Dolores, Paja, Miguel, Araujo-Castro, Marta, Ares, Jessica, Álvarez-Escola, Cristina, Vicente, Almudena, Álvarez Guivernau, Èlia, Novoa-Testa, Iria, Guerrero Perez, Fernando, Cámara, Rosa, Lecumberri, Beatriz, García Gómez, Carlos, Bernabéu, Ignacio, Manjón, Laura, Gaztambide, Sonia, Cordido, Fernando, Webb, Susan M. |
| المصدر: |
Frontiers in Endocrinology; 9/16/2022, Vol. 13, p1-10, 10p |
| مستخلص: |
Context: Some reports suggest that acromegaly in elderly patients has a more benign clinical behavior and could have a better response to first-generation long-acting somatostatin receptor ligands (SRL). However, there is no specific therapeutic protocol for this special subgroup of patients. Objective: This study aimed at identifying predictors of response to SRL in elderly patients. Design: Multicentric retrospective nationwide study of patients diagnosed with acromegaly at or over the age of 65 years. Results: One-hundred and eighteen patients (34 men, 84 women, mean age at diagnosis 71.7 ± 5.4 years old) were included. Basal insulin-like growth factor type 1 (IGF-1) above the upper limit of normal (ULN) and growth hormone (GH) levels (mean ± SD) were 2.7 ± 1.4 and 11.0 ± 11.9 ng/ml, respectively. The mean maximal tumor diameter was 12.3 ± 6.4 mm, and up to 68.6% were macroadenoma. Seventy-two out of 118 patients (61.0%) underwent surgery as primary treatment. One-third of patients required first-line medical treatment due to a rejection of surgical treatment or non-suitability because of high surgical risk. After first-line surgery, 45/72 (63.9%) were in disease remission, and 16/34 (46.7%) of those treated with SRL had controlled disease. Patients with basal GH at diagnosis ≤6 ng/ml had lower IGF-1 levels and had smaller tumors, and more patients in this group reached control with SRL (72.7% vs. 33.3%; p < 0.04) [OR: 21.3, IC: 95% (2.4-91.1)], while male patients had a worse response [OR: 0.09, IC 95% (0.01-0.75)]. The predictive model curve obtained for SRL response showed an AUC of 0.82 CI (0.71-0.94). Conclusions: The most frequent phenotype in newly diagnosed acromegaly in the elderly includes small adenomas and moderately high IGF-1 levels. GH at diagnosis β6 ng/ml and female gender, but not age per se, were associated with a greater chance of response to SRL. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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