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Pasireotide-pegvisomant combo induces disease control in treatment-resistant acromegaly

10 Nov 2019

Combined treatment with pasireotide and pegvisomant has been shown to control disease in tumours with low somatostatin receptor (SSTR) subtype 2 expression, resistant to conventional somatostatin analogues (SSAs; alone or combined with pegvisomant) and to new-generation SSAs alone (pasireotide), reports a recent study.

“Our data have reinforced the importance of personalized treatment of patients with acromegaly according to the clinical, biochemical, molecular and morphological disease markers,” the authors said.

This study described six patients who were successfully treated with a combination therapy of pasireotide and pegvisomant. Participants were then compared to a control group of patients resistant to conventional SSAs, whose disease was controlled with other treatment, such as pasireotide (as monotherapy) or pegvisomant (as monotherapy of combined with conventional SSAs).

Acromegaly in all six patients was controlled using the combination treatment with pasireotide and pegvisomant after failure of all other therapies. Giant and invasive pituitary adenomas (at both the cavernous sinus and other structures) were found in these six patients compared with the 49 patients in the control group.

Those receiving the combined treatment with pasireotide and pegvisomant had higher growth hormone levels, more elevated Ki-67 expression, greater SSTR subtype 5 expression and lower SSTR subtype 2 expression at the diagnosis of acromegaly as compared with those in the control group. However, this finding was not statistically significant.

“The treatment of acromegaly resistant to first- and second-line therapies can be extremely challenging,” the authors noted.

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Most Read Articles
2 days ago
During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
Pank Jit Sin, 14 Apr 2020
With the movement control order (MCO) in full gear, most conferences and meetings are being postponed or cancelled. Some have taken to having conferences and meetings in a virtual setting, such as the recently ended American College of Cardiology/World Congress of Cardiology (ACC.20/WCC) conference. MIMS and the Asian Young Pharmacist Group (AYPG) took this opportunity to engage with pharmacists in the form of a Zoom meeting. 
Pearl Toh, 05 Aug 2020
The direct oral anticoagulant apixaban may help prevent deaths when given at prophylactic or therapeutic doses in hospitalized COVID-19 patients with elevated D-dimer levels, according to an analysis presented during the ISTH 2020 Congress.