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Pasireotide treatment reduces cardiometabolic risk in Cushing's disease patients: an Italian, multicenter study

A Albani1, F Ferraù2, A Ciresi3

  • 1Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Endocrine
|February 1, 2018
PubMed

Insights

Pasireotide treatment for Cushing's disease significantly improved visceral adiposity index (VAI) and adipose tissue dysfunction (ATD). However, it also increased diabetes mellitus prevalence, despite no changes in cardiovascular risk scores.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Disorders

Background:

  • Cushing's disease (CD) is associated with metabolic disturbances and elevated cardiovascular mortality.
  • Visceral adiposity index (VAI) serves as a marker for visceral adipose tissue dysfunction (ATD) and associated cardiometabolic risk.

Purpose of the Study:

  • To assess the impact of 12-month pasireotide treatment on cardiometabolic risk markers in patients with Cushing's disease.

Main Methods:

  • A multicentre, prospective, observational study involving 16 CD patients treated with pasireotide for 12 months.
  • Anthropometric, clinical, and biochemical parameters were measured, including VAI, ATD severity, Framingham, and ASCVD risk scores, before and after treatment.

Main Results:

  • Pasireotide treatment significantly decreased 24h-urinary free cortisol, BMI, waist circumference, LDL-cholesterol, total-cholesterol, triglycerides, VAI, and ATD severity.
  • The prevalence of adipose tissue dysfunction (ATD) reduced significantly, with only 1 patient remaining affected after 12 months.
  • Despite improvements in VAI and ATD, the prevalence of diabetes mellitus and HbA1c levels significantly increased, while Framingham and ASCVD risk scores showed no significant change.

Conclusions:

  • Twelve-month pasireotide treatment effectively reduces VAI and ATD in Cushing's disease patients, indicating a positive impact on cardiometabolic risk.
  • These benefits are observed despite a lack of change in established cardiovascular risk scores and an increase in diabetes mellitus prevalence.
Abstract

Keywords:
Cardiometabolic riskCushing’s diseaseHypercortisolismPasireotideVisceral adiposity index

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