Photo Credit: Md Ariful Islam

The following is a summary of “Paradoxical GH response at OGTT does not predict Pasireotide efficacy but matters for glucose metabolism,” published in the January 2025 issue of Endocrinology by Occhi et al. 

Researchers conducted a retrospective study to investigate the predictive role of growth hormone paradox (GH-Par) on pasireotide response and adverse event development in patients with acromegaly.  

They collected data from a multicenter Italian retrospective cohort of 59 patients with acromegaly treated with pasireotide for at least 3 months. All patients underwent an OGTT to assess GH profiles. Patient response to pasireotide was defined as normalization of IGF-1 levels or a minimum 30% reduction in IGF-1 levels at the final follow-up visit.  

The results showed 59 patients with acromegaly with large (median 18 mm) and predominantly invasive (82%) adenomas, median baseline IGF-1 levels were 1.38 times the upper limit of normal (ULN) before pasireotide treatment. After a median treatment duration of 40 months, pasireotide effectively reduced IGF-1 levels, with 37 of 41 patients achieving normalization and 4 achieving a ≥30% reduction, 13 patients exhibited the GH-Par. Median pasireotide duration, dosage, and treatment efficacy were comparable between the GH-Par and non-GH-Par groups. However, the incidence of new-onset or worsening Glucose Metabolism Alterations (GMAs) after pasireotide was significantly higher in the GH-NPar group (from 37% to 80%, P < 0.001) compared to the GH-Par group (from 69% to 76%). This disparity may be attributed to a higher prevalence of pre-existing GMAs in the GH-Par group prior to pasireotide initiation (P = 0.038).  

Investigators concluded the GH-Par did not predict the response to pasireotide treatment but was associated with a better metabolic profile in patients with acromegaly. 

Source: pubmed.ncbi.nlm.nih.gov/39841390/