The correlation was also significant selleck chemicals when we analyzed all patients from Groups 1 and 2 whose final IGF-I levels were normal (Figure 2A), but not when analysis was limited to patients whose final IGF-I levels exceeded normal ranges (Figure 2B). Figure 1 Relationship between duration of PEGV Tipifarnib chemical structure therapy and final daily dose according to treatment regimen. Correlation between duration of PEGV therapy (months) and final daily PEGV dose (mg/day) in the total study population (A, upper panel, ●), Group 1 (B, middle panel, ■), and Group 2 (C, lower panel▲).

Regression coefficients (r) and p values are shown. Figure 2 Relationship between duration of PEGV therapy and final daily dose according to outcome. Correlation between duration of PEGV therapy (months) and final daily PEGV dose (mg/day) in all patients (both groups) with IGF-I normalization at the end of follow-up (A, upper panel, ◊) and all patients (both groups) with non-normalized IGF-I levels at the end of follow-up (B, lower panel, Δ). Regression coefficient (r) and p value are shown. Discussion This retrospective, observational study was conducted in 5 Italian hospitals to characterize Fer-1 the use of PEGV vs. PEGV?+?SSA regimens to

manage SSA-resistant acromegaly. We found that combination therapy was more likely to be prescribed for patients with clinical/biochemical/imaging evidence of relatively severe/aggressive disease along with a more substantial (albeit incomplete) IGF-I response to SSA monotherapy. Both regimens were well tolerated, and at the end of follow-up, there was no significant difference between the daily PEGV doses in the two groups. However, outcomes

(IGF-I normalization rates and final Interleukin-3 receptor IGF-I SDS) were significantly worse in the patients receiving PEGV?+?SSA. The only variable significantly related to the final PEGV doses in both groups was treatment duration. Given the size and nature of our sample, it is difficult to tell whether and to what extent our observations on prescribing practices are indicative of practices in other hospitals in Italy or other countries. The tendency to prescribe PEGV?+?SSA for acromegaly patients with more severe disease has not emerged from previous studies [8, 9, 12, 13, 16, 23, 24]. The only difference noted by Filopanti et al. in the Italian cohort they investigated was that patients on PEGV?+?SSA were more likely to have had macroadenomas at the time of diagnosis [24]. This was not observed in our population, although our Group 2 patients did have higher postoperative rates of residual tumor tissue. The increased disease severity in Group 2 was manifested by GH and IGF-I levels at diagnosis that were significantly higher than those in the group treated with PEGV alone. Our two treatment groups—like those analyzed by Reid et al. [25]—also had similar comorbidity rates when the disease was diagnosed.