Cardiometabolic Risk in Acromegaly: A Review With a Focus on Pasireotide

• Published in: Frontiers in endocrinology (Lausanne) Vol. 11; p. 28
• Main Authors: Puglisi, Soraya, Ferraù, Francesco, Ragonese, Marta, Spagnolo, Federica, Cannavò, Salvatore
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 06.02.2020
• Subjects: acromegaly; Acromegaly - complications; Acromegaly - drug therapy; Acromegaly - epidemiology; acromegaly treatment; Adenoma - complications; Adenoma - drug therapy; Adenoma - metabolism; cardiometabolic risk; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Endocrinology; GH-secreting pituitary tumor; Growth Hormone-Secreting Pituitary Adenoma - complications; Growth Hormone-Secreting Pituitary Adenoma - drug therapy; Growth Hormone-Secreting Pituitary Adenoma - metabolism; Heart Disease Risk Factors; Human Growth Hormone - blood; Humans; Insulin-Like Growth Factor I - metabolism; pasireotide; Risk Factors; Somatostatin - analogs & derivatives; Somatostatin - therapeutic use; Treatment Outcome; cardiometabolic risk; acromegaly; GH-secreting pituitary tumor; acromegaly treatment; pasireotide
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2020.00028

Acromegaly is a disease due to chronic GH excess and a consequent rise in IGF-1 levels. This rare endocrine condition is associated with metabolic alterations such as hyperglycaemia, dyslipidaemia, and systemic arterial hypertension, which, in addition to GH excess-related cardiovascular changes, play critical roles in increasing cardiovascular risk and mortality rates. Biochemical control of acromegaly, achieved by means of surgical, and/or medical treatment, positively impacts on cardiovascular risk factors and metabolic alterations, reducing overall patient mortality. However, treatment modalities of acromegaly and disease control differently impact on glucose homeostasis and lipid changes, and consequently on cardiometabolic risk. In this regard, pasireotide was shown to significantly influence glucose metabolism. This review summarizes the cardiometabolic consequences of acromegaly and its treatment, focusing on available data around the effects of medical therapy with pasireotide on factors that influence cardiometabolic risk.