Session: SAT 786-805-Diabetes & Obesity Therapeutics
Bench to Bedside
Poster Board SAT-798
Patients and Methods: 1762 patients with acromegaly treated with PEG were divided into groups with (DM) or without (non-DM) diabetes. DM was defined as: DM reported in medical history or HbA1c ≥ 6.5% or glucose >200 mg/dl or anti-diabetic medication before PEG start. Both cohorts were analyzed yearly for 4 years, and longitudinally at 1 and 4 years. Main clinical characteristics, previous treatments for acromegaly, PEG administration, glucose (G), HbA1c, serum IGF-I, concomitant treatments for DM and serious adverse events (SAEs) were studied.
Results: 510 patients (28.9%) had DM before PEG start and were comparable to the non-DM group (n=1252) in terms of previous treatments, duration of acromegaly (mean ± SD, 8.7 ± 9.1 yr vs 7.1 ± 7.5 yr, respectively) and duration of PEG treatment (5.2 ± 2.7 yr vs 5.4 ± 2.7 yr, respectively). In the DM group there was more women (57.1% vs 46.3%, p<0.0001), patients had higher BMI (31.2 ± 6.0 vs 28.6 ± 5.0 kg/m2 (p<0.0001) and were older at diagnosis (median, 47.0 vs 38.7 yr, p<0.0001). The proportion of patients with IGF-I concentrations above the ULN decreased from 83% to 47% (n=150) in the DM and from 85% to 39% (n=371) in the non-DM during the 4 yrs of follow-up. Among patients with elevated IGF-I at baseline, 53.7% vs 59.4% in the DM and non-DM, respectively, had normalized IGF-I at year 1. Their mean PEG dose (18.2 vs 15.3 mg/d) was higher (p=0.015) in the DM group (n=95) than in the non-DM group (n=274), and remained higher (p=0.028) at year 4.
In the DM group, G values changed from 138.7 ± 59.0 mg/dl (n=218) at baseline to 114.9 ± 42.1 mg/dl (n=208) at year 1 and to 120.2 ± 42.9 mg/dl at year 4 (n=184) with a nadir mean HbA1c value at year 1, 6.6 ± 1.2% (n=197) vs 6.9 ± 1.4% at baseline (n=198). In this group 58.6% had HbA1c above 6.5% at baseline, 42.1% at year 1, and 51.6% at year 4.
Treatment related SAEs were reported in 12 DM and 30 non-DM patients. PEG was discontinued in 6 DM and in 12 non-DM patients due to treatment related SAEs.
Conclusion: Patients with DM on PEG showed a moderate decrease in both glucose and HbA1c values. Overall PEG treatment was well tolerated.
Disclosure: TB: Advisory Group Member, Pfizer, Inc.. AL: Employee, Pfizer, Inc.. AC: Employee, Pfizer, Inc.. RG: Employee, Pfizer, Inc.. JH: Employee, Pfizer, Inc.. MK: Employee, Pfizer, Inc.. AJV: Advisory Group Member, Pfizer, Inc.. CJS: Advisory Group Member, Pfizer, Inc.. CC: Employee, Pfizer, Inc.. Nothing to Disclose: MD
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