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 novel mu...
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creator | Boscaro, M. Ludlam, W. H. Atkinson, B. Glusman, J. E. Petersenn, S. Reincke, M. Snyder, P. Tabarin, A. Biller, B. M. K. Findling, J. Melmed, S. Darby, C. H. Hu, K. Wang, Y. Freda, P. U. Grossman, A. B. Frohman, L. A. Bertherat, J. |
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 μg 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.
Results from this phase II study show pasireotide to be a promising pituitary-directed medical therapy for patients with Cushing’s disease. |
doi_str_mv | 10.1210/jc.2008-1008 |
format | Article |
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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 μg 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.
Results from this phase II study show pasireotide to be a promising pituitary-directed medical therapy for patients with Cushing’s disease.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2008-1008</identifier><identifier>PMID: 18957506</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Adrenocorticotropic hormone ; Adrenocorticotropic Hormone - blood ; Adult ; Aged ; Biological and medical sciences ; Blood Glucose - analysis ; Cortisol ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Glucagon - blood ; Hormones ; Humans ; Hydrocortisone - urine ; Hypothalamus. Hypophysis. Epiphysis (diseases) ; Insulin - blood ; Ligands ; Male ; Medical sciences ; Medical treatment ; Middle Aged ; Nervous system diseases ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Oligopeptides - adverse effects ; Oligopeptides - pharmacokinetics ; Oligopeptides - therapeutic use ; Patients ; Pituitary ; Pituitary ACTH Hypersecretion - drug therapy ; Pituitary ACTH Hypersecretion - metabolism ; Somatostatin ; Somatostatin - analogs & derivatives ; Surgery ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>The journal of clinical endocrinology and metabolism, 2009-01, Vol.94 (1), p.115-122</ispartof><rights>Copyright © 2009 by The Endocrine Society 2009</rights><rights>2009 INIST-CNRS</rights><rights>Copyright © 2009 by The Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-165ddc3d6d5e49ecdcc36510ef2c0b827d3c08787d227c8f6c19c365f33632953</citedby><cites>FETCH-LOGICAL-c461t-165ddc3d6d5e49ecdcc36510ef2c0b827d3c08787d227c8f6c19c365f33632953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21021391$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18957506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boscaro, M.</creatorcontrib><creatorcontrib>Ludlam, W. H.</creatorcontrib><creatorcontrib>Atkinson, B.</creatorcontrib><creatorcontrib>Glusman, J. E.</creatorcontrib><creatorcontrib>Petersenn, S.</creatorcontrib><creatorcontrib>Reincke, M.</creatorcontrib><creatorcontrib>Snyder, P.</creatorcontrib><creatorcontrib>Tabarin, A.</creatorcontrib><creatorcontrib>Biller, B. M. K.</creatorcontrib><creatorcontrib>Findling, J.</creatorcontrib><creatorcontrib>Melmed, S.</creatorcontrib><creatorcontrib>Darby, C. H.</creatorcontrib><creatorcontrib>Hu, K.</creatorcontrib><creatorcontrib>Wang, Y.</creatorcontrib><creatorcontrib>Freda, P. U.</creatorcontrib><creatorcontrib>Grossman, A. B.</creatorcontrib><creatorcontrib>Frohman, L. A.</creatorcontrib><creatorcontrib>Bertherat, J.</creatorcontrib><title>Treatment of Pituitary-Dependent Cushing’s Disease with the Multireceptor Ligand Somatostatin Analog Pasireotide (SOM230): A Multicenter, Phase II Trial</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><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 μg 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.
Results from this phase II study show pasireotide to be a promising pituitary-directed medical therapy for patients with Cushing’s disease.</description><subject>Adrenocorticotropic hormone</subject><subject>Adrenocorticotropic Hormone - blood</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - analysis</subject><subject>Cortisol</subject><subject>Endocrinopathies</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glucagon - blood</subject><subject>Hormones</subject><subject>Humans</subject><subject>Hydrocortisone - urine</subject><subject>Hypothalamus. Hypophysis. Epiphysis (diseases)</subject><subject>Insulin - blood</subject><subject>Ligands</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Nervous system diseases</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Oligopeptides - adverse effects</subject><subject>Oligopeptides - pharmacokinetics</subject><subject>Oligopeptides - therapeutic use</subject><subject>Patients</subject><subject>Pituitary</subject><subject>Pituitary ACTH Hypersecretion - drug therapy</subject><subject>Pituitary ACTH Hypersecretion - metabolism</subject><subject>Somatostatin</subject><subject>Somatostatin - analogs & derivatives</subject><subject>Surgery</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10VuL1DAYBuAiijuu3nktAVkPsF1zaNPGu2HWw8AsO7AjeFeyydeZDG1TkxTxzr-hP89fYkqLC6I3CYSH90vyJslTgi8IJfjNUV1QjMuUxOVesiAiy9OCiOJ-ssCYklQU9PNJ8sj7I8Yky3L2MDkhpciLHPNF8nPnQIYWuoBsjbYmDCZI9y29hB46PR6vBn8w3f7X9x8eXRoP0gP6asIBhQOgq6EJxoGCPliHNmYvO41ubCuD9UEG06FlJxu7R1vpo7PBaECvbq6vKMOv36LlFKDiHHDnaHsYw9drtHNGNo-TB7VsPDyZ99Pk0_t3u9XHdHP9Yb1ablKVcRJSwnOtFdNc55AJUFopxnOCoaYK35a00EzhsigLTWmhyporIkZRM8YZFTk7TV5Mub2zXwbwoWqNV9A0sgM7-IrzQvBMlBE-_wse7eDi-3zFCM-YKDDDUZ1PSjnrvYO66p1p459WBFdjY9VRVWNj1dhY5M_m0OG2BX2H54oiOJuB9Eo2tZOdMv6Pi4GUMEGiezk5O_T_G5nOI9kkY8NWOdNB78D7u9f886K_AWAAu9s</recordid><startdate>200901</startdate><enddate>200901</enddate><creator>Boscaro, M.</creator><creator>Ludlam, W. H.</creator><creator>Atkinson, B.</creator><creator>Glusman, J. E.</creator><creator>Petersenn, S.</creator><creator>Reincke, M.</creator><creator>Snyder, P.</creator><creator>Tabarin, A.</creator><creator>Biller, B. M. K.</creator><creator>Findling, J.</creator><creator>Melmed, S.</creator><creator>Darby, C. H.</creator><creator>Hu, K.</creator><creator>Wang, Y.</creator><creator>Freda, P. U.</creator><creator>Grossman, A. B.</creator><creator>Frohman, L. A.</creator><creator>Bertherat, J.</creator><general>Endocrine Society</general><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200901</creationdate><title>Treatment of Pituitary-Dependent Cushing’s Disease with the Multireceptor Ligand Somatostatin Analog Pasireotide (SOM230): A Multicenter, Phase II Trial</title><author>Boscaro, M. ; Ludlam, W. H. ; Atkinson, B. ; Glusman, J. E. ; Petersenn, S. ; Reincke, M. ; Snyder, P. ; Tabarin, A. ; Biller, B. M. K. ; Findling, J. ; Melmed, S. ; Darby, C. H. ; Hu, K. ; Wang, Y. ; Freda, P. U. ; Grossman, A. B. ; Frohman, L. A. ; Bertherat, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-165ddc3d6d5e49ecdcc36510ef2c0b827d3c08787d227c8f6c19c365f33632953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adrenocorticotropic hormone</topic><topic>Adrenocorticotropic Hormone - blood</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - analysis</topic><topic>Cortisol</topic><topic>Endocrinopathies</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glucagon - blood</topic><topic>Hormones</topic><topic>Humans</topic><topic>Hydrocortisone - urine</topic><topic>Hypothalamus. Hypophysis. Epiphysis (diseases)</topic><topic>Insulin - blood</topic><topic>Ligands</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Nervous system diseases</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Oligopeptides - adverse effects</topic><topic>Oligopeptides - pharmacokinetics</topic><topic>Oligopeptides - therapeutic use</topic><topic>Patients</topic><topic>Pituitary</topic><topic>Pituitary ACTH Hypersecretion - drug therapy</topic><topic>Pituitary ACTH Hypersecretion - metabolism</topic><topic>Somatostatin</topic><topic>Somatostatin - analogs & derivatives</topic><topic>Surgery</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boscaro, M.</creatorcontrib><creatorcontrib>Ludlam, W. H.</creatorcontrib><creatorcontrib>Atkinson, B.</creatorcontrib><creatorcontrib>Glusman, J. E.</creatorcontrib><creatorcontrib>Petersenn, S.</creatorcontrib><creatorcontrib>Reincke, M.</creatorcontrib><creatorcontrib>Snyder, P.</creatorcontrib><creatorcontrib>Tabarin, A.</creatorcontrib><creatorcontrib>Biller, B. M. K.</creatorcontrib><creatorcontrib>Findling, J.</creatorcontrib><creatorcontrib>Melmed, S.</creatorcontrib><creatorcontrib>Darby, C. H.</creatorcontrib><creatorcontrib>Hu, K.</creatorcontrib><creatorcontrib>Wang, Y.</creatorcontrib><creatorcontrib>Freda, P. U.</creatorcontrib><creatorcontrib>Grossman, A. B.</creatorcontrib><creatorcontrib>Frohman, L. A.</creatorcontrib><creatorcontrib>Bertherat, J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boscaro, M.</au><au>Ludlam, W. H.</au><au>Atkinson, B.</au><au>Glusman, J. E.</au><au>Petersenn, S.</au><au>Reincke, M.</au><au>Snyder, P.</au><au>Tabarin, A.</au><au>Biller, B. M. K.</au><au>Findling, J.</au><au>Melmed, S.</au><au>Darby, C. H.</au><au>Hu, K.</au><au>Wang, Y.</au><au>Freda, P. U.</au><au>Grossman, A. B.</au><au>Frohman, L. A.</au><au>Bertherat, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of Pituitary-Dependent Cushing’s Disease with the Multireceptor Ligand Somatostatin Analog Pasireotide (SOM230): A Multicenter, Phase II Trial</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2009-01</date><risdate>2009</risdate><volume>94</volume><issue>1</issue><spage>115</spage><epage>122</epage><pages>115-122</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>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 μg 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.
Results from this phase II study show pasireotide to be a promising pituitary-directed medical therapy for patients with Cushing’s disease.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>18957506</pmid><doi>10.1210/jc.2008-1008</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Adrenocorticotropic hormone Adrenocorticotropic Hormone - blood Adult Aged Biological and medical sciences Blood Glucose - analysis Cortisol Endocrinopathies Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Glucagon - blood Hormones Humans Hydrocortisone - urine Hypothalamus. Hypophysis. Epiphysis (diseases) Insulin - blood Ligands Male Medical sciences Medical treatment Middle Aged Nervous system diseases Non tumoral diseases. Target tissue resistance. Benign neoplasms Oligopeptides - adverse effects Oligopeptides - pharmacokinetics Oligopeptides - therapeutic use Patients Pituitary Pituitary ACTH Hypersecretion - drug therapy Pituitary ACTH Hypersecretion - metabolism Somatostatin Somatostatin - analogs & derivatives Surgery Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
title | Treatment of Pituitary-Dependent Cushing’s Disease with the Multireceptor Ligand Somatostatin Analog Pasireotide (SOM230): A Multicenter, Phase II Trial |
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