Long-Term Remission of Acromegaly after Octreotide Withdrawal Is an Uncommon and Frequently Unsustainable Event

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dc.citation.issue3
dc.citation.volume104
dc.contributor.authorCasagrande, Alessandra [UNIFESP]
dc.contributor.authorBronstein, Marcello Delano [UNIFESP]
dc.contributor.authorJallad, Raquel Soares [UNIFESP]
dc.contributor.authorMoraes, Aline B.
dc.contributor.authorElias, Paula C. L.
dc.contributor.authorCastro, Margaret
dc.contributor.authorCzepielewski, Mauro A.
dc.contributor.authorBoschi, Artur
dc.contributor.authorRibeiro-Oliveira, Antonio, Jr.
dc.contributor.authorSchweizer, Junia R. O. L.
dc.contributor.authorVilar, Lucio
dc.contributor.authorNazato, Debora Maria [UNIFESP]
dc.contributor.authorGadelha, Monica R.
dc.contributor.authorAbucham, Julio [UNIFESP]
dc.coverageBasel
dc.date.accessioned2020-07-31T12:46:50Z
dc.date.available2020-07-31T12:46:50Z
dc.date.issued2017
dc.description.abstractBackground: Long-term remission of acromegaly after somatostatin analog withdrawal has been reported in 18-42% of patients in studies with a relatively small number of patients using different inclusion and remission criteria. The objectives of this study were to establish the probability and predictive factors for short-and long-term remission [normal IGF-1 for age/sex: IGF-1 x upper limit of normal (ULN)] after octreotide long-acting release (LAR) withdrawal in a larger population of well-controlled patients with acromegaly (normal mean IGF-1 in the last 24 months). Methods: This is a prospective multicenter study in which 58 well-controlled patients with acromegaly receiving only octreotide LAR as a primary or postsurgical treatment were included in 14 university centers in Brazil. All patients had been on stable doses and dose intervals of octreotide LAR in the last year, and none had been submitted to radiotherapy. The main outcome measure was serum IGF-1 after 8 weeks (shortterm) and 60 weeks (long-term) of octreotide LAR withdrawal. Results: Seventeen of 58 patients (29%) were in remission in the short term, and only 4 patients achieved long-term remission after treatment withdrawal. The Kaplan-Meier estimated remission probability at 60 weeks was 7% and decreased to 5% at 72 weeks. The short-term remission rate was significantly higher (44%en
dc.description.abstractp = 0.017) in patients with pretreatment IGF-1 <2.4 x ULN. No other predictive factor for short-or long-term remission was found. Conclusion: Our results show that long-term remission of acromegaly afteroctreotide LAR withdrawal was an uncommon and frequently unsustainable event and do not support the recommendation of a systematic withdrawal of treatment in controlled patients. (C) 2016 S. Karger AG, Baselen
dc.description.affiliationUniv Fed Sao Paulo, Div Endocrinol & Metab, Neuroendocrine Unit, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Hosp Clin, Div Endocrinol & Metab, Neuroendocrine Unit, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Rio de Janeiro, Hosp Univ Clementino Fraga Filho, Endocrine Unit, Rio De Janeiro, Brazil
dc.description.affiliationUniv Sao Paulo, Ribeirao Preto Med Sch, Dept Internal Med, Ribeirao Preto, Brazil
dc.description.affiliationUniv Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Div Endocrinol, Grad Program Endocrinol, Porto Alegre, RS, Brazil
dc.description.affiliationUniv Fed Minas Gerais, Lab Endocrinol, Belo Horizonte, MG, Brazil
dc.description.affiliationUniv Fed Pernambuco, Hosp Clin, Div Endocrinol, Recife, PE, Brazil
dc.description.affiliationUnifespNeuroendocrine Unit, Division of Endocrinology and Metabolism, Universidade Federal de São Paulo
dc.description.affiliationUnifespUniversidade Federal de São Paulo (UNIFESP), Hosp Clin, Div Endocrinol & Metab, Neuroendocrine Unit, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.description.sponsorshipIDCAPES: 528/11
dc.format.extent273-279
dc.identifierhttp://dx.doi.org/10.1159/000446542
dc.identifier.citationNeuroendocrinology. Basel, v. 104, n. 3, p. 273-279, 2017.
dc.identifier.doi10.1159/000446542
dc.identifier.issn0028-3835
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56397
dc.identifier.wosWOS:000396797700006
dc.language.isoeng
dc.publisherKarger
dc.relation.ispartofNeuroendocrinology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectAcromegalyen
dc.subjectOctreotideen
dc.subjectRemissionen
dc.subjectSomatostatin analogen
dc.titleLong-Term Remission of Acromegaly after Octreotide Withdrawal Is an Uncommon and Frequently Unsustainable Eventen
dc.typeinfo:eu-repo/semantics/article
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