- |||||||||| A Case of Secondary Amenorrhea: Is It Only PCOS to Blame? (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_581;
Prolactin level ranging from 25-100 ng/mL is seen in medication-induced hyperprolactinemia, while particular medication like risperidone and phenothiazines can raise the level to more than 200 ng/mL. Newer agent paliperidone has been reported to induce hyperprolactinemia similarly to risperidone which explains significant prolactin elevation in this patient.
- |||||||||| Somavert (pegvisomant) / Pfizer
Novel dual antagonists of the growth hormone receptor and the prolactin receptor (W-178B) - May 11, 2023 - Abstract #ENDO2023ENDO_307;
Our laboratory has pioneered the discovery of the first and only FDA approved GHR antagonist - Somavert (pegvisomant for injection, Pfizer Inc., USA) - currently prescribed for the treatment of acromegaly...Thus, we present two distinct designs, preparation and characterization of dual antagonists of the GH action at the level of GHR and PRLR, with prospective applications in pathologies associated with a GH excess and also as valuable compounds to study the nature of human GH-GHR interactions. We currently continue to develop both compounds for pre-clinical validations.
- |||||||||| Journal: Extraocular Muscle Enlargement in Acromegaly. (Pubmed Central) - May 11, 2023
Abstract is embargoed at this time. Patients with acromegaly present with significantly enlarged EOMs compared with control subjects with nonfunctioning pituitary adenomas.
- |||||||||| Signifor (pasireotide) / Recordati
Biomarker, Review, Journal: Immunohistochemical evaluation of biomarkers with predictive role in acromegaly: a literature review. (Pubmed Central) - May 6, 2023
Several such molecular markers have been extensively studied through immunohistochemistry (IHC), among them the somatostatin receptors type 2 (SSTR-2) and type 5 (SSTR-5), which are known to correlate with response to somatostatin analogues treatment, the SSTR-2 negative tumors usually being resistant to first-generation analogues, while SSTR-5 potentially being a predictive marker for the novel agent, Pasireotide...Other novel markers, such as the E-cadherin cell-adhesion protein, the aryl hydrocarbon receptor-interacting protein (AIP), the cytoskeleton molecule filamin A (FLNA) and the Ki-67 nuclear antigen have also been the highlight of IHC studies on growth hormone (GH)-producing tumors, with promising results regarding their predictive roles for the outcome of acromegalic patients. In this review, we aimed to summarize the current knowledge on the role of IHC for acromegaly, highlighting the most important biomarkers that could offer valuable information for predicting treatment response, biological behavior, and prognosis.
- |||||||||| Review, Journal: Managing Estrogen Therapy in the Pituitary Patient. (Pubmed Central) - May 5, 2023
For hypopituitary women, estrogens should be replaced by a nonoral route. For acromegaly, oral estrogen formulations can be considered as simple adjuvant therapy for disease control.
- |||||||||| Somavert (pegvisomant) / Pfizer, Signifor (pasireotide) / Recordati, Signifor LAR (pasireotide long acting release) / Recordati
Biomarker, Journal: Modern approach to resistant acromegaly. (Pubmed Central) - May 1, 2023
In the last few years, in parallel with the increased number of medical options available for the therapy of acromegaly, relevant advances occurred in the understanding of the role of novel molecular and clinical biomarkers in predicting the responsiveness to second-line medical treatments, such as Pegvisomant and Pasireotide LAR, and helping clinicians in the personalization of the follow-up and treatment of resistant somatotroph adenomas. The integration of these findings into the existing guidelines may represent a possibly important step forward in the management of "difficult" acromegaly patients.
- |||||||||| cabergoline / Generic mfg., bromocriptine / Generic mfg.
Review, Journal: Diagnosis and Management of Pituitary Adenomas: A Review. (Pubmed Central) - Apr 29, 2023
Clinically manifest pituitary adenomas affect approximately 1 in 1100 people and can be complicated by syndromes of hormone excess as well as visual field defects and hypopituitarism from mass effect in larger tumors. First-line therapy for prolactinomas consists of bromocriptine or cabergoline, and transsphenoidal pituitary surgery is first-line therapy for other pituitary adenomas requiring treatment.
- |||||||||| Journal: Lipid profile abnormalities associated with endocrine disorders. (Pubmed Central) - Apr 19, 2023
Proper treatment of those disorders plays a crucial role in modifying the cardiovascular risk and improving the lipid profile of those patients. Even though lipid-lowering therapy is usually still needed, in some cases restoration of hormonal balance might be sufficient to normalize the lipid profile abnormalities.
- |||||||||| NN1213 / Novo Nordisk
Trial completion, Trial completion date, Surgery: LateRAc: Late Effects of Radiosurgery on Acromegaly Study (clinicaltrials.gov) - Apr 18, 2023
P=N/A, N=66, Completed,
Even though lipid-lowering therapy is usually still needed, in some cases restoration of hormonal balance might be sufficient to normalize the lipid profile abnormalities. Unknown status --> Completed | Trial completion date: Dec 2017 --> Apr 2023
- |||||||||| Review, Journal: Effects of endocrine disorders on lipids and lipoproteins. (Pubmed Central) - Apr 18, 2023
Treatment of acromegaly, GH deficiency, hypothyroidism, Cushing syndrome, and testosterone deficiency reduce LDL-C, although statin therapy may still be needed. Effects on ASCVD are not known.
- |||||||||| Review, Journal: New tools for bone health assessment in secreting pituitary adenomas. (Pubmed Central) - Apr 11, 2023
Several novel tools have been proposed as alternative or additional methods for the prediction of fractures, particularly in pituitary-driven osteopathies. This review highlights the novel potential biomarkers and diagnostic methods for bone fragility, including their pathophysiological, clinical, radiological, and therapeutic implications in acromegaly, prolactinomas, and Cushing's disease.
- |||||||||| Journal: Serum Elabela level is significantly increased in patients with acromegaly. (Pubmed Central) - Apr 4, 2023
Serum Elabela level can be used as an early and objective indicator of early cardiovascular involvement in patients with acromegaly. Further research is needed to clarify the role of serum Elabela levels on cardiovascular system in acromegaly patients.
- |||||||||| Somavert (pegvisomant) / Pfizer
Journal: Amino acid substitutions in human growth hormone affect secondary structure and receptor binding. (Pubmed Central) - Mar 29, 2023
The interaction between human Growth Hormone (hGH) and hGH Receptor (hGHR) has basic relevance to cancer and growth disorders, and hGH is the scaffold for Pegvisomant, an anti-acromegaly therapeutic...For E174Y (and certain mutations at other sites) the slowdown in on-rate was greater than that of the off-rate, leading to decreased affinity. The results point to a link between structure, zinc binding, and hGHR-binding affinity in hGH.
- |||||||||| Trial completion date, Trial primary completion date: Peri-operative Dynamics of the Growth Hormone Axis in Subjects With Acromegaly (clinicaltrials.gov) - Mar 28, 2023
P=N/A, N=20, Recruiting,
The results point to a link between structure, zinc binding, and hGHR-binding affinity in hGH. Trial completion date: Dec 2022 --> Dec 2023 | Trial primary completion date: Dec 2022 --> Dec 2023
- |||||||||| Journal: The role of elastography in the assessment of thyroid nodules in acromegaly. (Pubmed Central) - Mar 25, 2023
Thyroid nodules in acromegaly patients have a higher elasto score and the prevalence of hard nodules is higher in active disease. However, increased stiffness of nodules by US-E in patients with acromegaly does not seem to estimate the malignancy of the nodules.
- |||||||||| Journal: Treatment of acromegaly - data from the German Acromegaly Register (Pubmed Central) - Mar 25, 2023
As with numerous rare diseases, care in specialized centers and recording and evaluation in registry studies can contribute to better patient care and the optimization of therapy and diagnostic guidelines. We assume that with the help of the German Acromegaly Registry, which currently includes more than 2500 patients with acromegaly, we will be able to present a realistic picture of the care situation in Germany in the coming years.
- |||||||||| cabergoline / Generic mfg., milrinone / Generic mfg.
Uncontrolled Acromegaly Resulting in the Need for LVAD as Bridge to Heart Transplant (Station 15,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_322;
We assume that with the help of the German Acromegaly Registry, which currently includes more than 2500 patients with acromegaly, we will be able to present a realistic picture of the care situation in Germany in the coming years. The patient started on 0.5mg of Cabergoline twice weekly and 120mg weekly Lanreotide injections...The COVID-19 pandemic and insurance gaps led the patient to spend two years off his medicines and he was unable to be seen by his medical team.?
- |||||||||| Sandostatin LAR Depot (octreotide acetate) / Novartis
Co-secreting Pituitary Tumors- A Clinical Challenge (Station 10,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_311;
The patient started on 0.5mg of Cabergoline twice weekly and 120mg weekly Lanreotide injections...The COVID-19 pandemic and insurance gaps led the patient to spend two years off his medicines and he was unable to be seen by his medical team.? The other three declined surgery for the time being and were started on monthly long-acting Octreotide...Her cabergoline dose was increased and was referred for Trans-sphenoidal surgery.
- |||||||||| Orencia (abatacept) / BMS, Enbrel (etanercept) / Pfizer, Amgen, Humira (adalimumab) / Eisai, AbbVie
Acromegalic Arthropathy Masquerading as Rheumatoid Arthritis- A Diagnostic Challenge (Station 16,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_304;
70% of such patients have large-joint and axial arthropathy that includes thickened articular cartilage, periarticular calcifications, osteophyte overgrowth, and synovitis. About 40% of cases are initially diagnosed by an internist, and the rest are diagnosed when patients are seen by ophthalmologists for visual disturbances, by dental surgeons for bite disorders, by gynecologists for menstrual dysfunction and infertility, by rheumatologists for osteoarthritis, or by sleep-disorder specialists for obstructive sleep apnea.In conclusion, high suspicion of the diagnosis, along with early diagnosis, is critical in possibly preventing the morbidity associated with acromegaly and improving long-term outcomes.
- |||||||||| cabergoline / Generic mfg.
A Rare Case of Acromegaly with Negative Immunohistochemical Staining for Growth Hormone (Station 8,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_299;
After surgery he was started on cabergoline 0.5mg PO twice weekly...However, it has been suggested that sparse cytoplasmic stores of GH do not parallel the hypersecretion of GH and may reduce staining capacity. Thus, a diagnosis of acromegaly should be made in patients with clinical and biochemical findings, even in the absence of GH immunostaining.
- |||||||||| cabergoline / Generic mfg.
A Case of Familial Isolated Pituitary Adenoma Emphasizing an Often-Overlooked Aspect of Medical History (Station 11,The Poster Experience) - Mar 25, 2023 - Abstract #AACE2023AACE_293;
Thus, a diagnosis of acromegaly should be made in patients with clinical and biochemical findings, even in the absence of GH immunostaining. She was started on Cabergoline and that helped with normalization of prolactin levels.Discussion : FIPA is a rare hereditary disorder responsible for less than 2% of pituitary adenomas...Patients with positive mutation are recommended to undergo screening evaluation as follows-Growth assessment and evaluation for signs and symptoms of pituitary adenoma with pituitary function testsAge 4-30 years: annuallyAge 30-50 years: every 5 yearsPituitary MRI
- |||||||||| Biomarker, Journal: Gene Expression Profiling of Subcutaneous Adipose Tissue Reveals New Biomarkers in Acromegaly. (Pubmed Central) - Mar 24, 2023
She was started on Cabergoline and that helped with normalization of prolactin levels.Discussion : FIPA is a rare hereditary disorder responsible for less than 2% of pituitary adenomas...Patients with positive mutation are recommended to undergo screening evaluation as follows-Growth assessment and evaluation for signs and symptoms of pituitary adenoma with pituitary function testsAge 4-30 years: annuallyAge 30-50 years: every 5 yearsPituitary MRI AT in active acromegaly is associated with a gene expression profile of fibrosis and inflammation, which may corroborate the hyper-metabolic state and provide a means for identifying novel biomarkers.
- |||||||||| Review, Journal: The immune microenviroment in somatotropinomas: from biology to personalized and target therapy. (Pubmed Central) - Mar 21, 2023
Recent studies on tumor microenvironment (TME) provided new knowledge on the biology of these neoplasia, that may explain the different phenotypes of these tumors and suggest new biomarkers able to predict the prognosis and the treatment outcome. The identification of molecular markers that act as targets for biological therapies may open new perspectives in the medical treatments of aggressive pituitary tumors.In this paper, we will review data of TME and target therapies in somatotropinomas.
- |||||||||| Review, Journal: The hallmarks of cancer (Pubmed Central) - Mar 21, 2023
We also elaborate further on the existence of oncogene induced senescence in pituitary tumors. We conclude that a better understanding of these processes can help us dilucidated why pituitary tumors are so resistant to malignant transformation and can potentially contribute to the development of novel anticancer treatments.
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