The Journal of clinical endocrinology and metabolism · 2020
Treatment of Acromegalic Osteopathy in Real-life Clinical Practice: The BAAC (Bone Active Drugs in Acromegaly) Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Mazziotti Gherardo, Battista Claudia, Maffezzoni Filippo, Chiloiro Sabrina, Ferrante Emanuele, Prencipe Nunzia, Grasso Ludovica, Gatto Federico, Olivetti Roberto, Arosio Maura, Barale Marco, Bianchi Antonio, Cellini Miriam, Chiodini Iacopo, De Marinis Laura, Del Sindaco Giulia, Di Somma Carolina, Ferlin Alberto, Ghigo Ezio, Giampietro Antonella, Grottoli Silvia, Lavezzi Elisabetta, Mantovani Giovanna, Morenghi Emanuela, Pivonello Rosario, Porcelli Teresa, Procopio Massimo, Pugliese Flavia, Scillitani Alfredo, Lania Andrea Gerardo
Аннотация
BACKGROUND: Vertebral fractures (VFs) are a frequent complication of acromegaly, but no studies have been so far published on effectiveness of antiosteoporotic drugs in this clinical setting.
OBJECTIVE: To evaluate whether in real-life clinical practice bone active drugs may reduce the risk of VFs in patients with active or controlled acromegaly.
STUDY DESIGN: Retrospective, longitudinal study including 9 tertiary care endocrine units.
PATIENTS AND METHODS: Two hundred and forty-eight patients with acromegaly (104 males; mean age 56.00 ± 13.60 years) were evaluated for prevalent and incident VFs by quantitative morphometric approach. Bone active agents were used in 52 patients (20.97%) and the median period of follow-up was 48 months (range 12-132).
RESULTS: During the follow-up, 65 patients (26.21%) developed incident VFs in relationship with pre-existing VFs (odds ratio [OR] 3.75; P < .001), duration of active acromegaly (OR 1.01; P = .04), active acromegaly at the study entry (OR 2.48; P = .007), and treated hypoadrenalism (OR 2.50; P = .005). In the entire population, treatment with bone active drugs did not have a significant effect on incident VFs (P = .82). However, in a sensitive analysis restricted to patients with active acromegaly at study entry (111 cases), treatment with bone active drugs was associated with a lower risk of incident VFs (OR 0.11; P = .004), independently of prevalent VFs (OR 7.65; P < .001) and treated hypoadrenalism (OR 3.86; P = .007).
CONCLUSIONS: Bone active drugs may prevent VFs in patients with active acromegaly.
OBJECTIVE: To evaluate whether in real-life clinical practice bone active drugs may reduce the risk of VFs in patients with active or controlled acromegaly.
STUDY DESIGN: Retrospective, longitudinal study including 9 tertiary care endocrine units.
PATIENTS AND METHODS: Two hundred and forty-eight patients with acromegaly (104 males; mean age 56.00 ± 13.60 years) were evaluated for prevalent and incident VFs by quantitative morphometric approach. Bone active agents were used in 52 patients (20.97%) and the median period of follow-up was 48 months (range 12-132).
RESULTS: During the follow-up, 65 patients (26.21%) developed incident VFs in relationship with pre-existing VFs (odds ratio [OR] 3.75; P < .001), duration of active acromegaly (OR 1.01; P = .04), active acromegaly at the study entry (OR 2.48; P = .007), and treated hypoadrenalism (OR 2.50; P = .005). In the entire population, treatment with bone active drugs did not have a significant effect on incident VFs (P = .82). However, in a sensitive analysis restricted to patients with active acromegaly at study entry (111 cases), treatment with bone active drugs was associated with a lower risk of incident VFs (OR 0.11; P = .004), independently of prevalent VFs (OR 7.65; P < .001) and treated hypoadrenalism (OR 3.86; P = .007).
CONCLUSIONS: Bone active drugs may prevent VFs in patients with active acromegaly.