Search results for "Cushing's disease"

showing 10 items of 12 documents

Long-term safety and efficacy of subcutaneous pasireotide in patients with Cushing’s disease: interim results from a long-term real-world evidence st…

2019

Abstract Purpose Clinical trials have demonstrated the favorable efficacy/safety profile of pasireotide in patients with Cushing’s disease (CD). We report interim long-term results of an ongoing real-world evidence study of subcutaneous pasireotide in patients with CD. Methods Adults with CD receiving pasireotide, initiated before (prior-use) or at study entry (new-use), were monitored for ≤ 3 years during a multicenter observational study (http://clinicaltrials.gov identifier NCT02310269). Primary objective was to assess long-term safety of pasireotide alone or with other CD therapies. Results At the time of this interim analysis, 127 patients had received pasireotide (new-use, n = 31; pri…

AdultMalePediatricsmedicine.medical_specialtyEndocrinology Diabetes and MetabolismHypercortisolism030209 endocrinology & metabolismDiseaseArticleSettore MED/13 - Endocrinologia03 medical and health scienceschemistry.chemical_compound0302 clinical medicineEndocrinologyInterimmedicineHumansMulticenter Studies as TopicIn patientPituitary ACTH Hypersecretionbusiness.industryPituitary ACTH hypersecretionCushing's diseaseMiddle AgedCushing’s diseasemedicine.diseasePasireotidePasireotideClinical trialTreatment OutcomePituitarychemistryHyperglycemiaFemaleLong term safetySafetySomatostatinbusiness030217 neurology & neurosurgeryPituitary
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The medical treatment with pasireotide in Cushing’s disease: an Italian multicentre experience based on “real-world evidence”

2019

A phase III study has demonstrated that 6-month pasireotide treatment induced disease control with good safety in 15–26% of patients with Cushing’s disease (CD). The aim of the current study was to evaluate the 6-month efficacy and safety of pasireotide treatment according to the real-world evidence. Thirty-two CD patients started pasireotide at the dose of 600 µg twice a day (bid) and with the chance of up-titration to 900 µg bid, or down-titration to 450 or 300 µg bid, on the basis of urinary cortisol (UC) levels or safety. Hormonal, clinical and metabolic parameters were measured at baseline and at 3-month and 6-month follow-up, whereas tumour size was evaluated at baseline and at 6-mont…

AdultMalemedicine.medical_specialtyHydrocortisoneEndocrinology Diabetes and MetabolismUrinary system030209 endocrinology & metabolismDiseaseSomatostatin analoguesCushing’s disease; Medical treatment; Pasireotide; Pituitary tumour; Somatostatin analoguesBody Mass IndexYoung Adult03 medical and health scienceschemistry.chemical_compound0302 clinical medicineEndocrinologyInternal medicineDiabetes mellitusHumansMedicinePituitary NeoplasmsPituitary ACTH HypersecretionAdverse effectAgedmedicine.diagnostic_testbusiness.industryPituitary tumourCushing's diseaseMiddle AgedCushing’s diseasemedicine.diseaseMagnetic Resonance ImagingPasireotidePasireotideTreatment OutcomeItalychemistry030220 oncology & carcinogenesisCushing’s disease Medical treatment Pasireotide Pituitary tumour Somatostatin analoguesFemaleOriginal ArticleWaist CircumferenceSomatostatinbusinessLipid profileBody mass indexMedical treatment
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Effects of pasireotide treatment on coagulative profile: a prospective study in patients with Cushing's disease.

2018

Introduction: Cushing’s disease (CD) is characterized by procoagulative profile. Treatment with cortisol-reducing medications might normalize the coagulation impairment potentially eliminating the risk of thromboembolic complications. Aim: The aim of this prospective study is to evaluate the effectiveness of 6–12 months of treatment with pasireotide (Signifor®, Novartis) 600 µg twice daily on coagulative factors in 21 patients (16 females, mean age 46 ± 12.2 years) with CD. Biochemical, hormonal (urinary free cortisol, UFC; late night salivary cortisol, LNSC; ACTH) and coagulative parameters as Protrombin time (PT), aPTT, factors VIII, IX and XI, antithrombin III, protein C, protein S, fibr…

Cortisol secretionAdultBlood GlucoseMalemedicine.medical_specialtymedicine.drug_classEndocrinology Diabetes and Metabolism030209 endocrinology & metabolismGastroenterologySettore MED/13 - Endocrinologia03 medical and health scienceschemistry.chemical_compound0302 clinical medicineEndocrinologyInternal medicinemedicineHumansProspective StudiesProspective cohort studyThromboprophylaxisPituitary ACTH HypersecretionBlood CoagulationClotting factorCoagulationbusiness.industryAnticoagulantCoagulation; Cushing’s disease; Pasireotide; Pituitary; Thromboprophylaxis; Endocrinology Diabetes and Metabolism; EndocrinologyCushing's diseaseCushing’s diseaseMiddle Agedmedicine.diseasePasireotidePasireotideDiabetes and MetabolismCoagulative necrosisTreatment OutcomechemistryPituitary030220 oncology & carcinogenesisConcomitantThromboprophylaxiFemaleBlood Coagulation TestsbusinessSomatostatinEndocrine
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Corticotroph aggressive pituitary tumours and carcinomas frequently harbour ATRX mutations

2021

Abstract Context Aggressive pituitary tumors (APTs) are characterized by unusually rapid growth and lack of response to standard treatment. About 1% to 2% develop metastases being classified as pituitary carcinomas (PCs). For unknown reasons, the corticotroph tumors are overrepresented among APTs and PCs. Mutations in the alpha thalassemia/mental retardation syndrome X-linked (ATRX) gene, regulating chromatin remodeling and telomere maintenance, have been implicated in the development of several cancer types, including neuroendocrine tumors. Objective To study ATRX protein expression and mutational status of the ATRX gene in APTs and PCs. Design We investigated ATRX protein expression by us…

Male0301 basic medicineEndocrinology Diabetes and MetabolismClinical Biochemistrypituitary adenomapituitary carcinomaBiochemistryPATHWAYCohort Studies0302 clinical medicineEndocrinologyGene FrequencyTELOMERESCorticotrophsClinical Laboratory MedicineGenomicsMiddle AgedCushing’s diseaseEUROPEAN-SOCIETY3. Good healthEuropeKlinisk laboratoriemedicinACTH-Secreting Pituitary Adenoma030220 oncology & carcinogenesisDAXX/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_beingCushing's diseaseFemaleATRX (alpha thalassemia/mental retardation syndrome X-linked); aggressive PitNETs; pituitary carcinoma; pituitary adenoma; Cushings diseaseAcademicSubjects/MED00250EXPRESSIONAdenomaAdultX-linked Nuclear Proteinmedicine.medical_specialtyGENESAdolescentATRX (alpha thalassemia/mental retardation syndrome X-linked)3122 CancersNonsense mutationContext (language use)CLASSIFICATIONYoung Adult03 medical and health sciencesDeath-associated protein 6SDG 3 - Good Health and Well-beingPituitary adenomaInternal medicineADENOMASmedicineHumansGenetic Predisposition to DiseaseNeoplasm InvasivenessPituitary NeoplasmsClinical Research ArticlesATRXAgedCancer och onkologiaggressive PitNETsbusiness.industryCarcinomaBiochemistry (medical)Pituitary tumorsCancerAMPLIFICATIONNeuroendocrinologymedicine.disease030104 developmental biologyEndocrinologyPituitary3121 General medicine internal medicine and other clinical medicineCancer and OncologyMutationPituitary carcinomaCancer researchbusinessATRX (alpha thalassemia/mental retardation syndrome X-linked); Cushing’s disease; aggressive PitNETs; pituitary adenoma; pituitary carcinoma
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Pasireotide treatment reduces cardiometabolic risk in Cushing’s disease patients: an Italian, multicenter study

2018

Purpose: Patients with Cushing’s disease (CD) experience metabolic alterations leading to increased cardiovascular mortality. Recently, the visceral adiposity index (VAI) has been proposed as a marker of visceral adipose tissue dysfunction (ATD) and of the related cardiometabolic risk. We aimed to evaluate the impact of 12-month pasireotide treatment on cardiometabolic risk in CD patients. Methods: This is a multicentre, prospective, and observational study. Sixteen CD patients, referred to the Endocrine Units of the University Hospitals of Messina, Napoli, Padova, and Palermo (Italy), successfully treated with pasireotide for 12 month have been enrolled. In all patients, we assessed anthro…

MaleEndocrinology Diabetes and MetabolismCardiometabolic risk Cushing’s disease hypercortisolism pasireotide visceral adiposity indexLongitudinal StudieDisease030204 cardiovascular system & hematologySettore MED/13 - Endocrinologiachemistry.chemical_compound0302 clinical medicineEndocrinologyRisk FactorsMedicineLongitudinal StudiesProspective StudiesAdiposityFramingham Risk ScoreCushing’s diseaseCushing’s diseaseMiddle AgedPasireotideDiabetes and MetabolismHeart DiseaseItalyAtherosclerosiObesity AbdominalFemaleSomatostatinHumanAdultmedicine.medical_specialtyWaistHeart DiseasesHypercortisolism030209 endocrinology & metabolismIntra-Abdominal Fat03 medical and health sciencesMetabolic DiseasesInternal medicineDiabetes mellitusCardiometabolic risk; Cushing’s disease; Hypercortisolism; Pasireotide; Visceral adiposity index; Endocrinology Diabetes and Metabolism; EndocrinologyHumansPituitary ACTH Hypersecretionbusiness.industryRisk FactorCushing's diseaseAnthropometryAtherosclerosismedicine.diseasePasireotideCardiometabolic riskMetabolic DiseaseVisceral adiposity indexProspective StudiechemistryObservational studybusiness
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Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease: effects of corticotropin-releasing factor and thyrotropin-r…

1993

We sought to enhance the sensitivity of selective bilateral blood sampling to determine adrenocorticotropin (ACTH) and prolactin levels in the inferior petrosal sinus (IPS) by administering two stimulatory agents--corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH). We then determined the ACTH and prolactin levels in the IPS of 10 patients with Cushing's disease. After peripheral administration of both CRF and TRH, ACTH levels were significantly higher on the tumor side in all patients. The prolactin level was significantly higher on the tumor side when CRF or TRH was used to stimulate pituitary secretion. Postsurgical immunohistochemistry studies revealed productio…

Maleendocrine systemPituitary glandmedicine.medical_specialtyCorticotropin-Releasing HormoneThyrotropin-releasing hormonePituitary neoplasmPetrosal Sinus SamplingSensitivity and SpecificityCushing syndromeAdrenocorticotropic HormonePituitary Gland AnteriorInternal medicinemedicineHumansRadiology Nuclear Medicine and imagingPituitary NeoplasmsCushing SyndromeThyrotropin-Releasing Hormonebusiness.industryInferior petrosal sinusCushing's diseasemedicine.diseaseProlactinProlactinmedicine.anatomical_structureEndocrinologyFemaleCardiology and Cardiovascular Medicinebusinesshormones hormone substitutes and hormone antagonistsBlood samplingCardiovascular and interventional radiology
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Treatment of skeletal impairment in patients with endogenous hypercortisolism: when and how?

2014

Guidelines for the management of osteoporosis induced by endogenous hypercortisolism are not available. Both the American College of Rheumatology and the International Osteoporosis Foundation recommend to modulate the treatment of exogenous glucocorticoid-induced osteoporosis (GIO) based on the individual fracture risk profile (calculated by FRAX) and dose of glucocorticoid used, but it is difficult to translate corticosteroid dosages to different degrees of endogenous hypercortisolism, and there are no data on validation of FRAX stratification method in patients with endogenous hypercortisolism. Consequently, it is unclear whether such recommendations may be adapted to patients with endoge…

Oncologymedicine.medical_specialtyFRAXEndocrinology Diabetes and MetabolismOsteoporosisHypercortisolismAdrenal incidentaloma; Cushing's disease; Glucocorticoids; Osteoporosis; Bone Density Conservation Agents; Cushing Syndrome; Glucocorticoids; Humans; Osteoporosis; Osteoporotic Fractures; Risk FactorsEndogenyDiseaseadrenal incidentalomaBone remodelingRisk FactorsInternal medicinemedicineHumansCushing SyndromeBone Density Conservation Agentsglucocorticoidsbusiness.industrycushing's diseaseCushing's diseasemedicine.diseaseosteoporosisRheumatologyglucocorticoids; osteoporosis; cushing's disease; adrenal incidentalomaEndocrinologyAdrenal incidentaloma; CUSHING'S DISEASE; Glucocorticoids; OsteoporosisbusinessGlucocorticoidOsteoporotic Fracturesmedicine.drug
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MON-445 Long-Term Results of an Ongoing Non-Interventional, Real-World Observational Study of Pasireotide SC in Cushing's Disease

2019

Abstract Background: Clinical trials have shown that subcutaneous (sc) pasireotide effectively decreases urinary free cortisol (UFC), improves signs/symptoms and has a favorable safety profile in patients with Cushing’s disease (CD). We describe interim long-term safety and efficacy results of an ongoing multicenter observational study of pasireotide sc in real-world clinical practice for CD (NCT02310269). Methods: This study aims to enroll 100-200 adults with CD for whom surgery has failed or is not an option. Eligible patients could have started pasireotide before (prior use) or at (new use) study entry. Primary endpoint: incidence of pasireotide-related adverse events (AEs) and serious A…

Pediatricsmedicine.medical_specialtybusiness.industryEndocrinology Diabetes and MetabolismLong term resultsCushing's diseasemedicine.diseasePasireotidechemistry.chemical_compoundNeuroendocrinology and PituitarychemistryNon interventionalmedicineObservational studybusinessJournal of the Endocrine Society
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<p>Circulating Irisin Levels as a Marker of Osteosarcopenic-Obesity in Cushing’s Disease</p>

2020

Purpose To evaluate circulating irisin levels in patients with active and controlled Cushing's disease (CD). Design Forty-four patients with CD evaluated during the active phase and after 12 months of biochemical remission and 40 controls were recruited. Methods Phenotypic, anthropometric, hormonal and metabolic parameters, including insulin sensitivity estimation by homeostatic model of insulin resistance, Matsuda index and oral disposition index and circulating irisin levels were evaluated. Results Patients with active CD showed lower irisin levels compared to controls (p<0.001) and controlled CD (p<0.001). The independent variables significantly associated with irisin were waist circumf…

Pharmacologymedicine.medical_specialtyWaistbusiness.industryOsteoporosisCushing's diseasemedicine.diseaseBody fat percentageObesityEndocrinologyInsulin resistanceInternal medicineInternal MedicinemedicinebusinessHomeostasisHormoneDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy
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Pasireotide versus pituitary surgery: a retrospective analysis of 12 months of treatment in patients with Cushing’s disease

2017

Pituitary surgery represents the first-line treatment for most patients with Cushing’s disease (CD). In the case of surgery failure, additional treatment options are required. Pasireotide has shown favourable results in the first-line treatment of patients with CD, who are not candidates for surgery or in the second-line when surgery has failed. The aim of the current study is to compare the effects of surgery and pasireotide treatment in a cohort of patients with CD, and to evaluate the differences in response rate in terms of hormonal and clinical control, and improvement of metabolic complications

Pituitary glandmedicine.medical_specialtyEndocrinology Diabetes and Metabolism030209 endocrinology & metabolismpasireotide cushing diseaseSettore MED/13 - Endocrinologia03 medical and health scienceschemistry.chemical_compound0302 clinical medicineEndocrinologyDiabetes mellitusmedicineIn patientbusiness.industryPituitary ACTH hypersecretionRetrospective cohort studyCushing's diseasemedicine.diseasePasireotideSurgerymedicine.anatomical_structurechemistry030220 oncology & carcinogenesisPituitary surgerybusinessEndocrine
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