Open AccessEffects and Side Effects of Pasireotide Treatment in Cushing’s Disease: Experience of a Single Tertiary Center
Author(s) -
Hande Mefkure Özkaya,
Serdar Şahin,
Güler Kerimova,
Emre Durcan,
Cem Sulu,
Pınar Kadioğlu
Publication year - 2021
Publication title -
journal of the endocrine society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.046
H-Index - 20
ISSN - 2472-1972
DOI - 10.1210/jendso/bvab048.1309
Subject(s) - pasireotide , medicine , cushing's disease , context (archaeology) , gastroenterology , cushing syndrome , acromegaly , disease , growth hormone , paleontology , biology , hormone
Context: Cushing’s disease (CD), when uncontrolled despite surgery, requires medical treatment. In this vein, treatments with long-term effectiveness and safety profiles are needed. We aimed to evaluate the effects and side effects of pasireotide treatment in Cushing’s disease in the real world. Methods: Patients who were followed up for Cushing’s disease and treated with pasireotide between 2001-2019 at Cerrahpaşa Medical Faculty Endocrinology, Metabolism and Diabetes Department were evaluated. Pasireotide efficacy and side effects were evaluated. Results: Thirty-four patients were included in the study. The mean duration of treatment was 24.59 (SD ± 15.21) months. Urinary free cortisol (UFC) decreased in 40.59 % of the patients and normalized in 33.3 %. A total of %71.4 of the patients who were in remission at the 3rd month of the treatment preserved their remission status at last follow-up. A significant difference was found between pre-treatment and final UFC (p = 0.001), but the absence of remission at 3 months did not predict final remission (p = 0.274). ACTH decreased by 9.16 % (SD ± 46.67). A significant difference was found between ACTH levels at 3rd, 6 months, and last control (p = 0.014, 0.017, and 0.017, respectively). Serum cortisol decreased by 13.89 %. A significant difference was found between pre-treatment and 3rd month, pre-treatment and final cortisol (p = 0.034 and 0.013, respectively). The body weight decreased by an average of 5.5 [IQR (0.0-11.5)] kg. Cholecystectomy was performed in 3 patients (9%). The percentage of patients requiring antidiabetic medication increased from 33.3% at diagnosis to 81.8% at the last follow-up visit. A significant difference was found between pre-treatment and 3rd month fasting plasma glucose levels (p = 0.008). HbA1c increased by 17 %. There was a positive correlation between UFC and 3rd month HbA1c. All patients with hyperglycemia were controlled with effective antidiabetic therapy. Conclusion: Pasireotide treatment in CD is effective and safe, remission occurs in the first months of treatment and continues for a long time. Although hyperglycemia is the most common side effect, it is successfully controlled with antidiabetic medication.