The Journal of Clinical Endocrinology and Metabolism Journal Article

Antiosteoporotic Drugs in Acromegaly

August 31, 2020
 

Gherardo Mazziotti, Claudia Battista, Filippo Maffezzoni, Sabrina Chiloiro, Emanuele Ferrante, Nunzia Prencipe, Ludovica Grasso, Federico Gatto, Roberto Olivetti, Maura Arosio, Marco Barale, Antonio Bianchi, Miriam Cellini, Iacopo Chiodini, Laura De Marinis, Giulia Del Sindaco, Carolina Di Somma, Alberto Ferlin, Ezio Ghigo, Antonella Giampietro, Silvia Grottoli, Elisabetta Lavezzi, Giovanna Mantovani, Emanuela Morenghi, Rosario Pivonello, Teresa Porcelli, Massimo Procopio, Flavia Pugliese, Alfredo Scillitani, Andrea Gerardo Lania
The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 9, September 2020, dgaa363
https://doi.org/10.1210/clinem/dgaa363

Abstract

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.

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