Predictive factors and the management of hyperglycemia in patients with acromegaly and Cushing's disease receiving pasireotide treatment:

Pasireotide, a somatostatin receptor ligand, is approved for treating acromegaly and Cushing's disease (CD). Hyperglycemia during treatment can occur because of the drug's mechanism of action, although treatment discontinuation is rarely required. The prospective, randomized, Phase IV SOM230B2219 (NCT02060383) trial was designed to assess optimal management of pasireotide-associated hyperglycemia. Here, we investigated predictive factors for requiring antihyperglycemic medication during pasireotide treatment. Participants with acromegaly or CD initiated long-acting pasireotide 40 mg/28 days intramuscularly (acromegaly) or pasireotide 600 μg subcutaneously twice daily during pre-randomization (≤16 weeks). Those who did not need antihyperglycemic medication, were managed with metformin, or received insulin from baseline entered an observational arm ending at 16 weeks. Those who required additional/alternative antihyperglycemic medication to metformin were randomized to incretin-based therapy or insulin for an additional 16 weeks. Logistic-regression analyses evaluated quantitative and qualitative factors for requiring antihyperglycemic medication during pre-randomization. Of 190 participants with acromegaly and 59 with CD, 88 and 15, respectively, did not need antihyperglycemic medication; most were aged <40 years (acromegaly 62.5%, CD 86.7%), with baseline glycated hemoglobin (HbA Increasing age, HbA

Informations de copyright

Copyright © 2024 Feldt-Rasmussen, Bolanowski, Zhang, Yu, Witek, Kalra, Kietsiriroje, Piacentini, Pedroncelli and Samson.

Déclaration de conflit d'intérêts

UF-R reports travel grants and speaker honoraria from Ipsen, Recordati, and Novo Nordisk and advisory board fees from Novartis, Recordati, Novo Nordisk, and Xeris Pharmaceuticals Strongbridge. UF-R’s research salary was sponsored by a grant from Kirsten and Freddy Johansen’s Fund. MB reports receiving travel grants and speaker fees from Amryt, Recordati, Pfizer, Novartis, Ipsen, IBSA, Teva, and Berlin Chemie. PW reports receiving travel grants and speaker fees from Novartis, Ipsen, Recordati, Novo Nordisk, Xeris Pharmaceuticals (Strongbridge), and Lilly. PK reports participation in advisory board meetings by Novo Nordisk, Novartis, and Eli Lilly. AP is an employee of Recordati. AMP was an employee of Recordati when the analyses were conducted. SS has provided consultancy for Novartis and Chiasma. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.