Refractory nonfunctioning pituitary adenomas
AbstractNon-functioning pituitary adenomas (NFPAs) comprise silent tumors of different pituitary lineages that tend to escape early detection and present as invasive macroadenomas with symptoms of mass effect. Incomplete surgical resection is common and may be followed by significant rates of subsequent remnant progression. Pituitary tumors are defined as refractory when resistance to optimal standard therapies including surgery, radiotherapy, and medical treatment is documented. In the absence of approved medications for the treatment of NFPAs, the last criterion to classify these tumors as refractory is ill defined. Sile...
Source: Pituitary - February 14, 2023 Category: Endocrinology Source Type: research
UK practice on incidentally detected non-functioning pituitary microadenomas: analysis of two national surveys during a 12-year interval
ConclusionsDiagnostic and management approaches for microNFPAs have evolved in the UK. Biochemical investigations are performed in accord with consensus guidelines, though many clinicians perform annual biochemical surveillance without tumour growth/symptoms. A small number of clinicians request imaging beyond 5 years, but the frequency of imaging intervals until discharge remains variable. Robust evidence on the long-term natural history of microNFPAs is necessary to unify clinician approach. (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
Weekly somapacitan had no adverse effects on glucose metabolism in adults with growth hormone deficiency
ConclusionsSomapacitan, compared with daily GH, did not adversely affect glucose metabolism up to 86 weeks in a large cohort of treatment-naïve or previously treated patients with AGHD.Trial registrations (date of registration): NCT02229851 (2 September 2014), NCT02382939 (3 March 2015), NCT03075644 (7 March 2017). (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
A systematic literature review to evaluate extended dosing intervals in the pharmacological management of acromegaly
ConclusionsClinical efficacy/effectiveness, safety, and HRQoL outcomes in adults with acromegaly were similar and costs lower with EDIs versus standard regimens. Physicians may consider acromegaly treatment at EDIs, especially for patients with good disease control. (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
Post-operative surveillance for somatotroph, lactotroph and non-functional pituitary adenomas after curative resection: a systematic review
ConclusionsThis comprehensive review of the literature quantified the recurrence rates for commonly observed pituitary adenomas after transsphenoidal surgical resection with curative intent. Our findings suggest that surveillance within 1 year may be of low yield. Further clinical trials and cohort studies investigating cost-effectiveness of surveillance schedules and impact on quality of life of patients under surveillance will provide further insight to optimize follow-up. (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
UK practice on incidentally detected non-functioning pituitary microadenomas: analysis of two national surveys during a 12-year interval
ConclusionsDiagnostic and management approaches for microNFPAs have evolved in the UK. Biochemical investigations are performed in accord with consensus guidelines, though many clinicians perform annual biochemical surveillance without tumour growth/symptoms. A small number of clinicians request imaging beyond 5 years, but the frequency of imaging intervals until discharge remains variable. Robust evidence on the long-term natural history of microNFPAs is necessary to unify clinician approach. (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
A systematic literature review to evaluate extended dosing intervals in the pharmacological management of acromegaly
ConclusionsClinical efficacy/effectiveness, safety, and HRQoL outcomes in adults with acromegaly were similar and costs lower with EDIs versus standard regimens. Physicians may consider acromegaly treatment at EDIs, especially for patients with good disease control. (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
Post-operative surveillance for somatotroph, lactotroph and non-functional pituitary adenomas after curative resection: a systematic review
ConclusionsThis comprehensive review of the literature quantified the recurrence rates for commonly observed pituitary adenomas after transsphenoidal surgical resection with curative intent. Our findings suggest that surveillance within 1 year may be of low yield. Further clinical trials and cohort studies investigating cost-effectiveness of surveillance schedules and impact on quality of life of patients under surveillance will provide further insight to optimize follow-up. (Source: Pituitary)
Source: Pituitary - February 1, 2023 Category: Endocrinology Source Type: research
Pituitary enlargement in patients with cerebrospinal fluid drainage due to ventricular shunt insertion: know the condition and do not mistake for adenoma
ConclusionOur results confirmed a significant increase in pituitary size and volume, mimicking pituitary pathology, after v.-p. shunt insertion. This phenomenon can be explained by the Monro –Kellie doctrine, stating that intracranial depletion of CSF—as caused by v.p. shunting—leads to compensatory intracranial hyperemia, especially in the venous system, with the consequence of engorged venous sinuses, most likely responsible for enlargement of the pituitary gland. (Source: Pituitary)
Source: Pituitary - January 18, 2023 Category: Endocrinology Source Type: research
Glucose metabolism, gut-brain hormones, and acromegaly treatment: an explorative single centre descriptive analysis
ConclusionSSA impaired the insulin, glucagon, and incretin hormone secretions. Co-treatment with PEG seemed to counteract the somatostatinergic inhibition of the glucagon and insulin response to OGTT. We speculate that PEG may exert its action through GH-receptors on pancreatic δ-cells.Clinical trial registration NCT02005978. (Source: Pituitary)
Source: Pituitary - January 6, 2023 Category: Endocrinology Source Type: research
Serum biomarkers of colonic polyps in patients with acromegaly: a meta-analysis and systematic review
ConclusionWe present the first meta-analysis and systematic review of serum biomarkers in patients with acromegaly or colonic polyps. The prevalence of colonic lesion polyps, is associated with higher IGF-1 × ULN levels, higher insulin levels in acromegaly. Further research is required to confirm GH and serum soluble Klotho levels as biomarkers of colonic polyps. When IGF-1 × ULN, fasting insulin levels change in patients with acromegaly, the occurrence of colonic polyps should be monitored. Early detection may reduce the possibility of developing malignant colon neoplasms. (Source: Pituitary)
Source: Pituitary - December 21, 2022 Category: Endocrinology Source Type: research
