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Nelma Veronica Marques Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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Luiz Eduardo Armondi Wildemberg Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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Monica R Gadelha Neuroendocrinology Research Center, Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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dose reduction in two patients because of substantial IGF1 reduction ( 5 ). Herein, we present a retrospective analysis of a subset of patients who received long-term treatment with pasireotide, who maintained their biochemical response and had

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Jennifer Walsh The Mellanby Centre for Bone Research, The Medical School, The University of Sheffield, Sheffield, UK

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Neil Gittoes Centre for Endocrinology, Diabetes and Metabolism, University Hospitals Birmingham & University of Birmingham, Birmingham Health Partners, Birmingham, UK

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Peter Selby Department of Medicine, Manchester Royal Infirmary, Manchester, UK

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the Society for Endocrinology Clinical Committee The Society for Endocrinology, 22 Apex Court, Woodlands, Bradley Stoke, Bristol, UK

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Pamidronate 30–90 mg (depending on severity of hypercalcaemia) at 20 mg/h OR Ibandronic acid 2–4 mg Give more slowly and consider dose reduction in renal impairment Monitor serum calcium response: will reach nadir at 2–4 days Can cause hypocalcaemia

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Martin Zweifel Department of Medical Oncology, University Hospital Bern, Bern, Switzerland

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Beat Thürlimann Breast Centre St. Gallen, Kantonsspital St. Gallen, St. Gallen, Switzerland

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Salome Riniker Breast Centre St. Gallen, Kantonsspital St. Gallen, St. Gallen, Switzerland

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Patrik Weder Breast Centre St. Gallen, Kantonsspital St. Gallen, St. Gallen, Switzerland

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Roger von Moos Kantonsspital Graubünden, Chur, Switzerland

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Olivia Pagani Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland

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Martin Bigler SAKK Coordinating Centre, Bern, Switzerland

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Karin M Rothgiesser SAKK Coordinating Centre, Bern, Switzerland

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Christiane Pilop SAKK Coordinating Centre, Bern, Switzerland

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Hanne Hawle SAKK Coordinating Centre, Bern, Switzerland

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Peter Brauchli SAKK Coordinating Centre, Bern, Switzerland

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Coya Tapia Institute of Pathology, University of Bern, Bern, Switzerland

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Wolfgang Schoenfeld CURADIS GmbH, Erlangen, Germany

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Cristiana Sessa Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland

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for the Swiss Group for Clinical Cancer Research (SAKK)
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for phase 2. Dose modifications were planned for adverse events (AEs) grade 2 (dose reduction by one dose level) and grade 3 or 4 (stop treatment with CR1447 until resolved to grade ≤2 and restart one dose level lower until end of treatment). If an

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Angelica Sharma Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Deborah Papadopoulou Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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Karim Meeran Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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was established with an 8-h level of 16 μg/L. Patient C ( Fig. 3C ) was weaned from a prednisolone dose of 2 to 1 mg, with an 8-h level of 19 μg/L and a 6-h level of 36 μg/L. After this dose reduction, the baseline cortisol increased to 194 mmol/L, and

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Kathrin R Frey Department of Medicine I, Endocrine and Diabetes Unit, University Hospital, University of Würzburg, Würzburg, Germany

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Tina Kienitz Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Julia Schulz Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Manfred Ventz Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Kathrin Zopf Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Marcus Quinkler Endocrinology in Charlottenburg, Berlin, Germany

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patients with CAH reported an increase in L1-L4 BMD but a decrease of femoral neck BMD after 8–10 years ( 26 ); another study including 6 PAIs and 6 secondary AIs also showed a mixed response ( 27 ). Recently, we showed that a dose reduction in daily HC

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Peter Bond Department of Internal Medicine, Elisabeth TweeSteden Hospital, Tilburg, the Netherlands
Department of Performance and Image-enhancing Drugs Research, Android Health Clinic, Utrecht, the Netherlands

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Tijs Verdegaal Department of Internal Medicine, Elisabeth TweeSteden Hospital, Tilburg, the Netherlands
Department of Internal Medicine, Spaarne Gasthuis, Haarlem, the Netherlands

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Diederik L Smit Department of Internal Medicine, Elisabeth TweeSteden Hospital, Tilburg, the Netherlands
Department of Performance and Image-enhancing Drugs Research, Android Health Clinic, Utrecht, the Netherlands

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or two phlebotomies to accelerate the correction of hematocrit – with the dose reduction in order to persist this – is unlikely to cause harm. This, however, might be different for periodic phlebotomy in order to maintain decreased (or ‘corrected

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Daniel Bell Department of Pharmacy, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK

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Julia Hale Department of Endocrinology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK

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Cara Go Department of Endocrinology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK

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Ben G Challis Department of Endocrinology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK

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Tilak Das Department of Radiology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK

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Brian Fish Department of Head and Neck Surgery, Cambridge University NHS Foundation Trust, Cambridge, UK

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Ruth T Casey Department of Endocrinology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
Department of Medical Genetics, Cambridge University, Cambridge, UK

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identified in ten of these patients, most commonly intentional dose reductions/omissions due to nausea (four patients) or headaches (one case), along with problems obtaining a supply of medication (three patients) and unintentional non-adherence due to

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Jan Calissendorff Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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Henrik Falhammar Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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patients (15%) had adverse effects of iodine treatment (rash n  = 2, rash and vomiting n  = 1 and swelling of fingers n  = 1). This was managed with dose reduction in two and stopping LS prematurely in two. These four women were aged 30, 35, 43 and 61

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A Chinoy Royal Manchester Children’s Hospital, Manchester, UK

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M Skae Royal Manchester Children’s Hospital, Manchester, UK

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A Babiker King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia

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D Kendall Royal Preston Hospital, Preston, UK

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M Z Mughal Royal Manchester Children’s Hospital, Manchester, UK

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R Padidela Royal Manchester Children’s Hospital, Manchester, UK

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, resolution of intercurrent illness results in normalisation of cCa, such that close monitoring and dose reduction to baseline is needed to prevent hypercalcaemia and hypercalciuria. rhPTH(1–34) may have a role in these situations. The mechanisms underlying

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Marek Niedziela Department of Pediatric Endocrinology and Rheumatology, Institute of Pediatrics, Karol Jonscher’s Clinical Hospital, Poznan University of Medical Sciences, Poznan, Poland

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(a dose reduction or change of medication may be sufficient): 1) Pruritus, urticaria (1–5%), sometimes very severe skin symptoms – they can be controlled with antihistamines or by changing the antithyroid drug 2) Muscle and joint pain (in

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