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Introduction:
Adult-onset growth hormone deficiency (AGHD) is usually the last deficiency to be substituted in hypopituitarism. In children with documented GH deficiency, treatment without delay is crucial for achieving optimal effects on growth and development. In adults, it is not known whether a delay in treatment initiation influences biochemical response and the favourable physiological effects resulting from GH replacement therapy (GHRT).
Methods:
A total of 1085 GH-deficient adults from KIMS (Pfizer International Metabolic Database) were included, adequately replaced with all pituitary hormones except for GH at baseline. Patients were stratified by sex and age (20–50 years and ≥50 years) and subsequently divided into two groups below and above the median duration of unsubstituted AGHD for that subgroup. The median time of unsubstituted GHD for the total cohort was 2.53 years (P5 = 0.35, P95 = 24.42).
Results:
Beneficial effects of 4 years of GHRT were observed on lipids and quality of life in all subgroups. A decrease in waist circumference was observed only in older (>50 years) patients. There was no difference in IGF-I SDS and in GH dose required to normalize IGF-I in patients with a duration of unsubstituted AGHD above or below the median. No relevant differences were found between the groups for anthropometric measures, cardiovascular risk factors and quality of life scores.
Conclusion:
In contrast to GHD in children and adolescents, no difference could be established in treatment response between early or late initiation of GHRT in AGHD in terms of required GH dose, IGF-I, metabolic health and quality of life.
Department of Endocrinology, St James’s Hospital, Dublin, Ireland
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Department of Endocrinology, University of Manchester, Manchester, UK
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Department of Paediatric Endocrinology & Diabetes, Newcastle-upon-Tyne Hospitals, Newcastle upon Tyne, UK
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Endocrine Research Group, Institute of Genetic Medicine, University of Newcastle-upon-Tyne, Newcastle upon Tyne, UK
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presented with life-changing injuries resulting from major self-harm episode influenced by low self-esteem. Median age at treatment initiation was 56 years (range 38.4–69.5). Treatment over the first year was with IM Sustanon 250 mg administered monthly
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Division of Endocrinology and Metabolism, Diabetes Center, Kurume Medical Center, Kokubu-machi, Kurume-city, Fukuoka, Japan
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Division of Endocrinology and Metabolism, Diabetes Center, Kurume Medical Center, Kokubu-machi, Kurume-city, Fukuoka, Japan
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glucose consumption rate ( 12 ) in the muscle. However, it remained unclear whether SGLT2 inhibitor administration can improve insulin sensitivity and rapidly reduce plasma glucose concentrations in humans during the early phase of treatment initiation
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Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Department of Internal Medicine, Herlev Gentofte Hospital, Copenhagen, Denmark
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Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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National Research Centre for the Working Environment, Copenhagen, Denmark
QualityMetric Incorporated, LLC, Johnston, Rhode Island, USA
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University Hospital), were invited to complete ThyPRO prior to and 6 weeks after treatment initiation. At follow-up, patients also rated their change since baseline; both overall and for each of 13 specific domains measured by ThyPRO. Aiming at samples around
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onset of hypothyroidism and hyperT in patients treated with durvalumab was 42 and 43 days, respectively. In fact, the range of time to the occurrence of a thyroid-related iAE was very large and varied from 1 day after treatment initiation to 31 months
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Objective
To evaluate the safety and efficacy of letrozole in girls with progressive precocious puberty (PP) associated with McCune–Albright syndrome (MAS).
Design
Monocentric retrospective cross-sectional and longitudinal study of consecutive patients.
Patients
Ten MAS patients treated at Peking Union Medical College Hospital between September 1999 and December 2017 were retrospectively reviewed; those with complications due to PP were followed.
Results
The mean age at letrozole initiation was 4.5 ± 2.6 years, while the mean duration of treatment was 3.3 ± 2.4 years. Letrozole was highly effective at decreasing the rate of skeletal maturation, with a significant decrease in the bone age-to-chronological age (BA/CA) ratio from 1.9 ± 1.1 pre-treatment to 1.5 ± 1.2 on letrozole treatment (P = 0.016). Moreover, growth velocity Z-scores declined from 0.41 ± 0.5 to −0.2 ± 0.31 with treatment (P < 0.001). Predicted adult height Z-scores increased significantly from −2.03 ± 2.33 at baseline to 1.13 ± 0.84 following treatment initiation (P = 0.029). Moreover, vaginal bleeding declined significantly on letrozole.
Conclusions
Our findings suggest that letrozole may be an effective therapy in some girls with MAS, as treatment results in improved BA/CA ratio, growth velocity and predicted adult height. Possible adverse effects include nettle rash.
Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
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Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
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Department of Radiology, HUS Medical Imaging Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Department of Radiology, HUS Medical Imaging Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Endocrinology, Abdominal Centre, University of Helsinki and HUS, Helsinki, Finland
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Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
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multidisciplinary meeting before treatment initiation. We collected the following data from the patient records: patient age at treatment initiation, sex, and ECOG performance status. Furthermore, we listed the characteristics of metastatic disease, including
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Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France
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Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France
Inserm UMR1185, Le Kremlin Bicetre, Paris, France
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Inserm UMR1185, Le Kremlin Bicetre, Paris, France
Paris-Saclay University, Paris, France
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Helsinki. Results Patient characteristics At treatment initiation, there was no significant clinical difference in the two groups concerning the following assessment: patient age (5.1 ± 3.5 months in the pump group vs 13 ± 17.7 months in the
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aneurysm. The first four patients had no reported SAEs. The abdominal aortic aneurysm was diagnosed in a patient with a PTPN11 mutation 2.2 years after GH treatment initiation. This patient was also diagnosed with Crohn’s disease (1.8 years after
Center for Neuroendocrine Tumors, ENETS Center of Excellence, Netherlands Cancer Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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Department of Clinical Chemistry, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Department of Gastroenterology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Center for Neuroendocrine Tumors, ENETS Center of Excellence, Netherlands Cancer Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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received sunitinib (2%). Treatment response was defined as PFS ≥ 12 months after treatment initiation. A total of 34 patients showed response to treatment (69%). The median TTP after the start of treatment was 20 months (2–66 months). Significant