A prospective study on the efficacy of oral estrogen in female patients with acromegaly.
Acromegaly
/ drug therapy
Adenoma
/ drug therapy
Delayed-Action Preparations
/ therapeutic use
Estrogens
/ therapeutic use
Female
Human Growth Hormone
/ metabolism
Humans
Insulin-Like Growth Factor I
/ metabolism
Octreotide
/ therapeutic use
Peptides, Cyclic
/ therapeutic use
Prospective Studies
Somatostatin
/ therapeutic use
Treatment Outcome
Acromegaly
ER-α
Oral estrogen
Pituitary adenomas
Somatotropinoma
Journal
Pituitary
ISSN: 1573-7403
Titre abrégé: Pituitary
Pays: United States
ID NLM: 9814578
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
accepted:
16
12
2021
pubmed:
29
1
2022
medline:
9
6
2022
entrez:
28
1
2022
Statut:
ppublish
Résumé
To evaluate the efficacy and safety of oral estrogen therapy in female patients of childbearing age with uncontrolled acromegaly and to verify the significance of the presence of estrogen receptor α (ER-α) in somatotropinomas. Prospective study in which biochemical and radiological evaluations were performed at baseline and after six months of treatment with an oral formulation of ethinyl-estradiol 0.03 mg and levonorgestrel 0.15 mg. ER-α was assessed by immunohistochemistry and immunopositivity was considered when it was present in ≥ 1% of cells. Eight patients with uncontrolled acromegaly were selected. All patients underwent surgery. Four patients were on octreotide LAR 30 mg, two patients were on lanreotide autogel 120 mg, and two patients had active disease after surgery. At the end of follow-up, IGF-I normalized in 3/8 (37%), 2/8 (25%) patients presented with mean IGF-I reduction of 25% but without IGF-I normalization, and 2/8 (25%) did not respond-one had a 13% increase in IGF-I and IGF-I level remained unchanged after treatment in the other. In one patient, treatment was discontinued after 3 months due to side effects (headache), with an IGF-I reduction of 28% but without normalization. Tumor volume increase (41%) was observed in only one patient (the only tumor with positive ER-α expression). In uncontrolled patients with acromegaly, a trial with oral estrogen can be an option for young women. Oral estrogen was well tolerated, but the somatotropinoma that presented ER-α expression was the only somatotropinoma that presented growth during treatment.
Identifiants
pubmed: 35088193
doi: 10.1007/s11102-021-01204-w
pii: 10.1007/s11102-021-01204-w
doi:
Substances chimiques
Delayed-Action Preparations
0
Estrogens
0
Peptides, Cyclic
0
Human Growth Hormone
12629-01-5
Somatostatin
51110-01-1
Insulin-Like Growth Factor I
67763-96-6
Octreotide
RWM8CCW8GP
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
433-443Subventions
Organisme : Conselho Nacional de Desenvolvimento Científico e Tecnológico
ID : 171144/2017-1
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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