Multivariable Prediction Model for Biochemical Response to First-Generation Somatostatin Receptor Ligands in Acromegaly

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Coopmans, EC (Author) Other; Korevaar, TIM (Author) Other; van Meyel, SWF (Author) Other; Daly, AF (Author) Other; Chanson, P (Author) Other; Brue, T (Author) Other; Delemer, B (Author) Other; Hana, V (Author) Other; Colao, A (Author) Other; Carvalho, Davide (Author) FMUP; Jaffrain Rea, ML (Author) Other; Stalla, GK (Author) Other; Fajardo Montanana, C (Author) Other; Beckers, A (Author) Other; van der Lely, AJ (Author) Other; Petrossians, P (Author) Other; Neggers, SJCMM (Author) Other

Journal

Title: Journal of Clinical Endocrinology and Metabolism

Vol. 105

Pages: 2964-2974

ISSN: 0021-972X

Publisher: Endocrine Society

Indexing

ISI Web of Knowledge - 6 Citations

Scopus - 12 Citations

Other information

Authenticus ID: P-00S-GXE

DOI: 10.1210/clinem/dgaa387

Abstract (EN): Context: First-generation somatostatin receptor ligands (fg-SRLs) represent the mainstay of medical therapy for acromegaly, but they provide biochemical control of disease in only a subset of patients. Various pretreatment biomarkers might affect biochemical response to fg-SRLs. Objective: To identify clinical predictors of the biochemical response to fg-SRLs monotherapy defined as biochemical response (insulin-like growth factor (IGF)-1 <= 1.3 x ULN (upper limit of normal)), partial response (>20% relative IGF-1 reduction without normalization), and nonresponse (<= 20% relative IGF-1 reduction), and IGF-1 reduction. Design: Retrospective multicenter study. Setting: Eight participating European centers. Methods: We performed a meta-analysis of participant data from 2 cohorts (Rotterdam and Liege acromegaly survey, 622 out of 3520 patients). Multivariable regression models were used to identify predictors of biochemical response to fg-SRL monotherapy. Results: Lower IGF-1 concentration at baseline (odds ratio (OR) = 0.82, 95% confidence interval (CI) 0.72-0.95 IGF-1 ULN, P = .0073) and lower bodyweight (OR = 0.99, 95% CI 0.98-0.99 kg, P = .038) were associated with biochemical response. Higher IGF-1 concentration at baseline (OR = 1.40, (1.19-1.65) IGF-1 ULN, P <= .0001), the presence of type 2 diabetes (oral medication OR = 2.48, (1.43-4.29), P = .0013; insulin therapy OR = 2.65, (1.02-6.70), P = .045), and higher bodyweight (OR = 1.02, (1.01-1.04) kg, P = .0023) were associated with achieving partial response. Younger patients at diagnosis are more likely to achieve nonresponse (OR = 0.96, (0.94-0.99) year, P = .0070). Baseline IGF-1 and growth hormone concentration at diagnosis were associated with absolute IGF-1 reduction (beta = 0.90, standard error (SE) = 0.02, P <= .0001 and beta = 0.002, SE = 0.001, P = .014, respectively). Conclusion: Baseline IGF-1 concentration was the best predictor of biochemical response to fg-SRL, followed by bodyweight, while younger patients were more likely to achieve nonresponse.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11