作者
Betina Biagetti,Marta Araujo‐Castro,Miguel Pocovı́,Iría Novoa-Testa,Fernando Cordido,Eider Pascual‐Corrales,Víctor Rodríguez Berrocal,Fernando Guerrero‐Pérez,Almudena Vicente,Juan Carlos Percovich,Rogelio García Centeno,Laura González Fernández,María Dolores Ollero García,Ana Irigaray,María Dolores Moure Rodríguez,Cristina Novo-Rodríguez,María Calatayud,Rocío Villar-Taibo,Ignacio Bernabéu,Cristina Álvarez-Escolá,Pamela Benítez Valderrama,Carmen Tenorio Jiménez,Pablo Abellán Galiana,Eva Venegas Moreno,Inmaculada González Molero,Pedro Iglesias,Concepción Blanco,Fernando Vidal-Ostos De Lara,Paz de Miguel,Elena López Mezquita,Felicia A. Hanzu,Ibán Aldecoa,Silvia Aznar,Cristina Lamas,Anna Aulinas,Queralt Asla,Paola Gracia,José María Recio Córdova,Mariola Aviles,Diego Asensio-Wandosel,Miguel Sampedro‐Núñez,Rosa Cámara,Miguel Paja,Ignacio Ruz‐Caracuel,Carmen Fajardo,Esteban Cordero,Elena Martínez‐Sáez,Mónica Marazuela,Manel Puig‐Domingo
摘要
Abstract Objective The aim of this study is to compare the response to first-line medical treatment in treatment-naive acromegaly patients with pure growth hormone (GH)-secreting pituitary adenoma (GH-PA) and those with GH and prolactin cosecreting PA (GH&PRL-PA). Design This is a retrospective multicentric study of acromegaly patients followed from 2003 to 2023 in 33 tertiary Spanish hospitals with at least 6 months of first-line medical treatment. Methods Baseline characteristics, first-line medical treatment strategies, and outcomes were analyzed. We employed a multiple logistic regression full model to estimate the impact of some baseline characteristics on disease control after each treatment modality. Results Of the 144 patients included, 72.9% had a GH-PA, and 27.1% had a GH&PRL-PA. Patients with GH&PRL-PA were younger (43.9 ± 15.0 vs 51.9 ± 12.7 years, P < .01) and harboring more frequently macroadenomas (89.7% vs 72.1%, P = .03). First-generation somatostatin receptor ligand (fgSRL) as monotherapy was given to 106 (73.6%) and a combination treatment with fgSRL and cabergoline in the remaining 38 (26.4%). Patients with GH&PRL-PA received more frequently a combination therapy (56.4% vs 15.2%, P < .01). After 6 months of treatment, in the group of patients under fgSRL as monotherapy, those patients with GH&PRL-PA had worse control compared to GH-PAs (29.4% vs 55.1%, P = .04). However, these differences in the rate of disease control between both groups disappeared when both received combination treatment with fgSRL and cabergoline. Conclusion In GH&PRL-PA, the biochemical control achieved with fgSRL as monotherapy is substantially worse than in patients harboring GH-PA, supporting the inclusion of cabergoline as first-line medical treatment in combination with fgSRLs in these subgroups of patients.