Are there country-specific differences in the use of pegvisomant for acromegaly in clinical practice? An analysis from ACROSTUDY.

Abstract

OBJECTIVE:

A comprehensive picture of pegvisomant use for treating acromegaly in routine clinical practice in different countries is lacking. We aimed, therefore, to document country-specific behaviors in real-life pegvisomant use, and the main safety and effectiveness outcomes in the ACROSTUDY.

DESIGN:

ACROSTUDY is an open-label, non-interventional, post-marketing safety surveillance study.

METHODS:

A descriptive analysis was performed using data from the six top-recruiter ACROSTUDY countries, i.e., Germany (n = 548 patients), Italy (n = 466), France (n = 312), USA (n = 207), Spain (n = 200) and the Netherlands (n = 175). These nations accounted for > 85% of the ACROSTUDY cases.

RESULTS:

The mean pegvisomant dose at treatment start was lowest in the Netherlands (9.4 mg/day), whereas it ranged between 10.9 and 12.6 mg/day in the other countries. At year 5, the mean pegvisomant dose was around 15 mg/day in all countries, except France (18.1 mg/day). At starting pegvisomant, patients treated with monotherapy ranged between 15% in the Netherlands and 72% in Spain. Monotherapy remained lowest over time in the Netherlands. In all countries, the percentage of patients with normal IGF-1 increased steeply from < 20% at baseline to 43-58% at month 6 and 51-67% at year 1. After that, we observed minor changes in the rate of acromegaly control in all countries. The Netherlands peaked in disease control at year 2 (72%). The proportion of patients reporting changes in pituitary tumor size was generally low. Serious treatment-related adverse events were < 5% in all countries.

CONCLUSIONS:

Our study provided a detailed summary of real-life use of pegvisomant in the six top-recruiter ACROSTUDY nations.

• Authors: S Grottoli, A Bianchi, F Bogazzi, C Bona, M O Carlsson, A Colao, F Dassie, A Giampietro, R Gomez, S Granato, P Maffei, R Pivonello, N Prencipe, M Ragonese, C Urbani, S Cannavò
• Journal: Journal of endocrinological investigation (J Endocrinol Invest) Vol. 45 Issue 8 Pg. 1535-1545 (Aug 2022) ISSN: 1720-8386 [Electronic] Italy
• PMID: 35359232 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Chemical References

• Receptors, Somatotropin
• Human Growth Hormone
• Insulin-Like Growth Factor I
• pegvisomant

Topics

• Acromegaly (chemically induced, drug therapy)
• Human Growth Hormone (adverse effects, analogs & derivatives)
• Humans
• Insulin-Like Growth Factor I
• Pituitary Neoplasms (drug therapy)
• Receptors, Somatotropin