How to position pasireotide LAR treatment in acromegaly

Eva C. Coopmans, Ammar Muhammad, Aart J. Van Der Lely, Joseph A.M.J.L. Janssen, Sebastian J.C.M.M. Neggers

Onderzoeksoutput: Bijdrage aan tijdschriftArtikel recenserenpeer review

36 Citaten (Scopus)

Samenvatting

Context: Pasireotide long-acting release (LAR) is a somatostatin multireceptor ligand, and in the current consensus criteria pasireotide LAR is considered the second-line medical treatment for acromegaly. We present in this article our recommendations to define the position of pasireotide LAR in the treatment of acromegaly and provide recommendations for the management of pasireotide-induced hyperglycemia. Evidence Acquisition: Our recommendations are based on our experiences with the pasireotide LAR and pegvisomant (PEGV) combination study and the available basic or clinical articles published in peer-reviewed international journals on pasireotide LAR and acromegaly. Evidence Synthesis: In accordance with the current consensus criteria, we recommend pasireotide LAR monotherapy as a second-line therapy in young patients who show tumor growth during first-generation somatostatin receptor ligand (SRL) therapy and in patients who show tumor growth during PEGV therapy. In addition, we recommend pasireotide LAR monotherapy in patients with headache not responsive to first-generation SRL therapy and in patients who experience side effects or are intolerant to PEGV monotherapy. In contrast to the current consensus criteria, we recommend considering combination therapy with pasireotide LAR and PEGV as third-line treatment in patients without diabetes at low PEGV dosages (#80 mg/week) and in patients with tumor growth or symptoms of active acromegaly during first-generation SRL and PEGV combination therapy. With respect to pasireotide-induced hyperglycemia, we recommend a more liberal strategy of blood glucose monitoring during pasireotide treatment. Conclusions: In contrast to the current consensus criteria, we recommend a more reluctant use of pasireotide LAR therapy for the treatment of acromegaly.

Originele taal-2Engels
Pagina's (van-tot)1978-1988
Aantal pagina's11
TijdschriftJournal of Clinical Endocrinology and Metabolism
Volume104
Nummer van het tijdschrift6
DOI's
StatusGepubliceerd - 1 jun. 2019
Extern gepubliceerdJa

Vingerafdruk

Duik in de onderzoeksthema's van 'How to position pasireotide LAR treatment in acromegaly'. Samen vormen ze een unieke vingerafdruk.

Citeer dit