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

Coopmans, Eva C.; Korevaar, Tim I. M.; van Meyel, Sebastiaan W. F.; Daly, Adrian; Chanson, Philippe; Brue, Thierry; Delemer, Brigitte; Hána, Václav; Colao, Annamaria; Carvalho, Davide; Jaffrain-Rea, Marie-Lise; Stalla, Günter K.; Fajardo-Montañana, Carmen; Beckers, Albert; van der Lely, Aart J.; Petrossians, Patrick; Neggers, Sebastian J. C. M. M.

doi:10.1210/clinem/dgaa387

Article (Scientific journals)

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

Coopmans, Eva C.; Korevaar, Tim I. M.; van Meyel, Sebastiaan W. F. et al.

2020 • In Journal of Clinical Endocrinology and Metabolism, 105 (9)

Peer reviewed

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https://hdl.handle.net/2268/249982

DOI
10.1210/clinem/dgaa387

PubMed
32589751

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Keywords :

acromegaly; biochemical response; first-generation somatostatin receptor ligands

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 × 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 Liège 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 (β = 0.90, standard error (SE) = 0.02, P ≤ .0001 and β = 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.

Disciplines :

Endocrinology, metabolism & nutrition

Author, co-author :

Coopmans, Eva C.

Korevaar, Tim I. M.

van Meyel, Sebastiaan W. F.

Daly, Adrian ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie

Chanson, Philippe

Brue, Thierry

Delemer, Brigitte

Hána, Václav

Colao, Annamaria

Carvalho, Davide

More authors (7 more)

Language :

English

Title :

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

Publication date :

2020

Journal title :

Journal of Clinical Endocrinology and Metabolism

ISSN :

0021-972X

eISSN :

1945-7197

Volume :

105

Issue :

Peer reviewed :

Peer reviewed

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since 07 August 2020

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