Evidence map›Paper›PMID 38809458›Full record

ArticleJournal of endocrinological investigation2024

Insights from an Italian Delphi panel: exploring resistance to first-generation somatostatin receptor ligands and guiding second-line medical therapies in acromegaly management.

S Grottoli, P Maffei, A S Tresoldi, S Granato, L Benedan, P Mariani, A Giustina

Abstract read
In one paragraph

Article in Journal of endocrinological investigation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

S Grottoli *Department of Medical Science, Division of Endocrinology, Diabetes and Metabolism, University of Turin, Turin, Italy. silvia.grottoli@unito.it.ORCID http://orcid.org/0000-0002-7742-4499
P Maffei *Department of Medicine (DIMED), 3rd Medical Clinic, Padua University Hospital, Padua, Italy.
A S TresoldiMedical Department, Pfizer Italia, Rome, Italy.
S GranatoMedical Department, Pfizer Italia, Rome, Italy.
L BenedanUniversità Milano-Bicocca, Milan, Italy.
P MarianiUniversità Milano-Bicocca, Milan, Italy.
A GiustinaInstitute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFirst-line medical therapy for acromegaly management includes first-generation somatostatin receptor ligands (fgSRLs), but resistance limits their use. Despite international guidelines, the choice of second-line therapy is debated.

methodsWe aim to discuss resistance to fgSRLs, identify second-line therapy determinants and assess glycemia's impact to provide valuable insights for acromegaly management in clinical practice. A group of Italian endocrinologists expert in the pituitary field participated in a two-round Delphi panel between July and September 2023. The Delphi questionnaire encompassed a total of 75 statements categorized into three sections: resistance to fgSRLs therapy and predictors of response; determinants for the selection of second-line therapy; the role of glycemia in the therapeutic management. The statements were rated on a 6-point Likert scale.

resultsFifty-nine (79%) statements reached a consensus. IGF-1 levels resulted central for evaluating resistance to fgSRLs, that should be defined considering also symptomatic clinical response, degree of tumor shrinkage and complications, using clinician- and patient-reported outcome tools available. Factors to be evaluated for the choice of second-line medical therapy are hyperglycemia-that should be managed as in non-acromegalic patients-tumor remnant, resistant headache and compliance. Costs do not represent a main determinant in the choice of second-line medical treatment.

conclusionThe experts agreed on a holistic management approach to acromegaly. It is therefore necessary to choose currently available highly effective second-line medical treatment (pegvisomant and pasireotide) based on the characteristics of the patients.

Indexed as

AcromegalyDelphi TechniqueDrug ResistanceReceptors, SomatostatinDisease ManagementHuman Growth HormoneHumansItalyLigandsSomatostatinSurveys and QuestionnairesHuman Growth HormoneLigandsReceptors, SomatostatinSomatostatinAcromegalyDelphiPasireotidePegvisomantSomatostatin receptor ligands (SRLs)Type 2 diabetes mellitus

Identifiers

PMID38809458
PMCPMC11549125

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.