TY - JOUR
T1 - Treatment of Acromegalic Osteopathy in Real-life Clinical Practice
T2 - The BAAC (Bone Active Drugs in Acromegaly) Study
AU - Mazziotti, Gherardo
AU - Battista, Claudia
AU - Maffezzoni, Filippo
AU - Chiloiro, Sabrina
AU - Ferrante, Emanuele
AU - Prencipe, Nunzia
AU - Grasso, Ludovica
AU - Gatto, Federico
AU - Olivetti, Roberto
AU - Arosio, Maura
AU - Barale, Marco
AU - Bianchi, Antonio
AU - Cellini, Miriam
AU - Chiodini, Iacopo
AU - De Marinis, Laura
AU - Del Sindaco, Giulia
AU - Di Somma, Carolina
AU - Ferlin, Alberto
AU - Ghigo, Ezio
AU - Giampietro, Antonella
AU - Grottoli, Silvia
AU - Lavezzi, Elisabetta
AU - Mantovani, Giovanna
AU - Morenghi, Emanuela
AU - Pivonello, Rosario
AU - Porcelli, Teresa
AU - Procopio, Massimo
AU - Pugliese, Flavia
AU - Scillitani, Alfredo
AU - Lania, Andrea Gerardo
PY - 2020/9/1
Y1 - 2020/9/1
N2 - 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.
AB - 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.
KW - acromegaly
KW - bisphosphonates
KW - bone-active drugs
KW - denosumab
KW - osteoporosis
KW - teriparatide
KW - vertebral fractures
UR - http://www.scopus.com/inward/record.url?scp=85088495183&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088495183&partnerID=8YFLogxK
U2 - 10.1210/clinem/dgaa363
DO - 10.1210/clinem/dgaa363
M3 - Article
C2 - 32511698
AN - SCOPUS:85088495183
VL - 105
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 9
M1 - dgaa363
ER -