Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial.
CONTEXT: There is currently no medical therapy for Cushing's disease that targets the pituitary adenoma. Availability of such a medical therapy would be a valuable therapeutic option for the management of this disorder. OBJECTIVE: Our objective was to evaluate the short-term efficacy of the nov...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2009
|
| _version_ | 1797057536203948032 |
|---|---|
| author | Boscaro, M Ludlam, W Atkinson, B Glusman, J Petersenn, S Reincke, M Snyder, P Tabarin, A Biller, B Findling, J Melmed, S Darby, C Hu, K Wang, Y Freda, P Grossman, AB Frohman, L Bertherat, J |
| author_facet | Boscaro, M Ludlam, W Atkinson, B Glusman, J Petersenn, S Reincke, M Snyder, P Tabarin, A Biller, B Findling, J Melmed, S Darby, C Hu, K Wang, Y Freda, P Grossman, AB Frohman, L Bertherat, J |
| author_sort | Boscaro, M |
| collection | OXFORD |
| description | CONTEXT: There is currently no medical therapy for Cushing's disease that targets the pituitary adenoma. Availability of such a medical therapy would be a valuable therapeutic option for the management of this disorder. OBJECTIVE: Our objective was to evaluate the short-term efficacy of the novel multireceptor ligand somatostatin analog pasireotide in patients with de novo, persistent, or recurrent Cushing's disease. DESIGN: We conducted a phase II, proof-of-concept, open-label, single-arm, 15-d multicenter study. PATIENTS: Thirty-nine patients with either de novo Cushing's disease who were candidates for pituitary surgery or with persistent or recurrent Cushing's disease after surgery without having received prior pituitary irradiation. INTERVENTION: Patients self-administered sc pasireotide 600 microg twice daily for 15 d. MAIN OUTCOME MEASURE: Normalization of urinary free cortisol (UFC) levels after 15 d treatment was the main outcome measure. RESULTS: Of the 29 patients in the primary efficacy analysis, 22 (76%) showed a reduction in UFC levels, of whom five (17%) had normal UFC levels (responders), after 15 d of treatment with pasireotide. Serum cortisol levels and plasma ACTH levels were also reduced. Steady-state plasma concentrations of pasireotide were achieved within 5 d of treatment. Responders appeared to have higher pasireotide exposure than nonresponders. CONCLUSIONS: Pasireotide produced a decrease in UFC levels in 76% of patients with Cushing's disease during the treatment period of 15 d, with direct effects on ACTH release. These results suggest that pasireotide holds promise as an effective medical treatment for this disorder. |
| first_indexed | 2024-03-06T19:37:49Z |
| format | Journal article |
| id | oxford-uuid:1fa2beb9-ce6d-4f1c-a38b-5b827f7e585a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:37:49Z |
| publishDate | 2009 |
| record_format | dspace |
| spelling | oxford-uuid:1fa2beb9-ce6d-4f1c-a38b-5b827f7e585a2022-03-26T11:23:05ZTreatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1fa2beb9-ce6d-4f1c-a38b-5b827f7e585aEnglishSymplectic Elements at Oxford2009Boscaro, MLudlam, WAtkinson, BGlusman, JPetersenn, SReincke, MSnyder, PTabarin, ABiller, BFindling, JMelmed, SDarby, CHu, KWang, YFreda, PGrossman, ABFrohman, LBertherat, JCONTEXT: There is currently no medical therapy for Cushing's disease that targets the pituitary adenoma. Availability of such a medical therapy would be a valuable therapeutic option for the management of this disorder. OBJECTIVE: Our objective was to evaluate the short-term efficacy of the novel multireceptor ligand somatostatin analog pasireotide in patients with de novo, persistent, or recurrent Cushing's disease. DESIGN: We conducted a phase II, proof-of-concept, open-label, single-arm, 15-d multicenter study. PATIENTS: Thirty-nine patients with either de novo Cushing's disease who were candidates for pituitary surgery or with persistent or recurrent Cushing's disease after surgery without having received prior pituitary irradiation. INTERVENTION: Patients self-administered sc pasireotide 600 microg twice daily for 15 d. MAIN OUTCOME MEASURE: Normalization of urinary free cortisol (UFC) levels after 15 d treatment was the main outcome measure. RESULTS: Of the 29 patients in the primary efficacy analysis, 22 (76%) showed a reduction in UFC levels, of whom five (17%) had normal UFC levels (responders), after 15 d of treatment with pasireotide. Serum cortisol levels and plasma ACTH levels were also reduced. Steady-state plasma concentrations of pasireotide were achieved within 5 d of treatment. Responders appeared to have higher pasireotide exposure than nonresponders. CONCLUSIONS: Pasireotide produced a decrease in UFC levels in 76% of patients with Cushing's disease during the treatment period of 15 d, with direct effects on ACTH release. These results suggest that pasireotide holds promise as an effective medical treatment for this disorder. |
| spellingShingle | Boscaro, M Ludlam, W Atkinson, B Glusman, J Petersenn, S Reincke, M Snyder, P Tabarin, A Biller, B Findling, J Melmed, S Darby, C Hu, K Wang, Y Freda, P Grossman, AB Frohman, L Bertherat, J Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial. |
| title | Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial. |
| title_full | Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial. |
| title_fullStr | Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial. |
| title_full_unstemmed | Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial. |
| title_short | Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial. |
| title_sort | treatment of pituitary dependent cushing s disease with the multireceptor ligand somatostatin analog pasireotide som230 a multicenter phase ii trial |
| work_keys_str_mv | AT boscarom treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT ludlamw treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT atkinsonb treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT glusmanj treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT petersenns treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT reinckem treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT snyderp treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT tabarina treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT billerb treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT findlingj treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT melmeds treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT darbyc treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT huk treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT wangy treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT fredap treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT grossmanab treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT frohmanl treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial AT bertheratj treatmentofpituitarydependentcushingsdiseasewiththemultireceptorligandsomatostatinanalogpasireotidesom230amulticenterphaseiitrial |