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<p>First-generation somatostatin receptor ligands (SRLs) are first-line medical therapy for acromegaly. During long-term treatment, hepato-biliary-pancreatic adverse events can occur. This study aimed to evaluate the prevalence and predictors of hepato-biliary-pancreatic adverse events during SRL-treatment.</p><p>In this multicenter study, data of 371 acromegaly patients (223 females) were retrospectively collected at the start of SRL therapy (T0), and at the last follow-up visit (120 ± 97.31 months). The occurrence of hepato-biliary-pancreatic adverse events and their relationship with features at T0 were investigated.</p><p>Sixty-one patients (16.4%) underwent cholecystectomy (CH-Tx), cholecystitis (CH) occurred in 3.8%, severe or mild hyperlipasemia/hyperamylasemia in 2.2% and in 5.1%, severe or mild hypertransaminasemia in 1.1% and in 6.4%,respectively. No significant differences emerged after patient stratification by gender or age (≤/&gt;50yrs). BMI, GH and IGF1 values were not associated with a higher risk of biliary complications. Patients undergoing CH-Tx or CH had a higher prevalence of cholelithiasis at T0 (<i>p</i> = 0.002 and <i>p</i> = 0.005). Cholelithiasis (<i>p</i> = 0.040) and biliary sludge (<i>p</i> = 0.014) at T0 were independent predictors of cholecystectomy. Cholelithiasis also strongly predicted cholecystitis in both univariable (<i>p</i> = 0.012) and multivariable (<i>p</i> = 0.025) analyses. Ursodeoxycholic acid (UDCA) treatment was associated with cholecystitis (<i>p</i> = 0.007) and mild-hypertransaminasemia (<i>p</i> = 0.035). When considering overall hepato-biliary-pancreatic adverse events, cholelithiasis, biliary sludge and age at T0 were significant predictors in both univariate (<i>p</i> = 0.006,<i>p</i> = 0.010,<i>p</i> = 0.013) and multivariable analysis (<i>p</i> = 0.029,<i>p</i> = 0.028,<i>p</i> = 0.044).</p><p>Hepato-biliary-pancreatic adverse events are not infrequent during long-term SRLs therapy and are influenced overall by older age, cholelithiasis and biliary sludge.</p>

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Adverse hepato-biliary-pancreatic events in acromegaly patients treated with first generation somatostatin receptor ligands

  • 期刊论文

  • 发表日期：

    2026年4月4日

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  • Francesco Ferraù,
  • Elena Sofia Blanca,
  • Marta Ragonese,
  • Angela Alibrandi,
  • Marianna Martino,
  • Giorgio Arnaldi,
  • Luigi Simone Aversa,
  • Daniela Cuboni,
  • Silvia Grottoli,
  • Francesco Giorgino,
  • Anna Leonardini,
  • Ylenia Alessi,
  • Carla Paola Costa,
  • Giordana Siracusano,
  • Giovanni Squadrito,
  • Giulia Carosi,
  • Alessandra Mangone,
  • Giovanna Mantovani,
  • Salvatore Cannavò

摘要

First-generation somatostatin receptor ligands (SRLs) are first-line medical therapy for acromegaly. During long-term treatment, hepato-biliary-pancreatic adverse events can occur. This study aimed to evaluate the prevalence and predictors of hepato-biliary-pancreatic adverse events during SRL-treatment.

In this multicenter study, data of 371 acromegaly patients (223 females) were retrospectively collected at the start of SRL therapy (T0), and at the last follow-up visit (120 ± 97.31 months). The occurrence of hepato-biliary-pancreatic adverse events and their relationship with features at T0 were investigated.

Sixty-one patients (16.4%) underwent cholecystectomy (CH-Tx), cholecystitis (CH) occurred in 3.8%, severe or mild hyperlipasemia/hyperamylasemia in 2.2% and in 5.1%, severe or mild hypertransaminasemia in 1.1% and in 6.4%,respectively. No significant differences emerged after patient stratification by gender or age (≤/>50yrs). BMI, GH and IGF1 values were not associated with a higher risk of biliary complications. Patients undergoing CH-Tx or CH had a higher prevalence of cholelithiasis at T0 (p = 0.002 and p = 0.005). Cholelithiasis (p = 0.040) and biliary sludge (p = 0.014) at T0 were independent predictors of cholecystectomy. Cholelithiasis also strongly predicted cholecystitis in both univariable (p = 0.012) and multivariable (p = 0.025) analyses. Ursodeoxycholic acid (UDCA) treatment was associated with cholecystitis (p = 0.007) and mild-hypertransaminasemia (p = 0.035). When considering overall hepato-biliary-pancreatic adverse events, cholelithiasis, biliary sludge and age at T0 were significant predictors in both univariate (p = 0.006,p = 0.010,p = 0.013) and multivariable analysis (p = 0.029,p = 0.028,p = 0.044).

Hepato-biliary-pancreatic adverse events are not infrequent during long-term SRLs therapy and are influenced overall by older age, cholelithiasis and biliary sludge.