Reduction in serum biomarkers of acromegaly post-surgery and post-pharmacotherapy: are insulin-like growth factor (IGF)-1 and soluble (s)Klotho levels decreased to a similar extent?

Anand, Gurpreet; Bernays, René L.; Neidert, Marian C.; Regli, Luca; Sze, Lisa; Tschopp, Oliver; Zwimpfer, Cornelia; Schmid, Christoph

doi:10.1530/endoabs.63.p1066

Cited by 1 publication

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“…In our study the improvement of QoL correlated with the improvement in serum sKlotho (i.e., a greater absolute reduction in sKlotho). This is line with previous data suggesting that sKlotho levels are elevated in patients with active acromegaly and decrease toward the normal range after surgery [14,15] and/or first-generation SRLs [16,17]. This suggests that sKlotho might be a potentially useful biomarker in assessing QoL in acromegaly patients.…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, we observed that improvement in serum sKlotho corresponds with improvement in serum IGF-1. This is in line with the previous study of Anand et al that showed that IGF-1 and sKlotho levels decrease to a similar extent during surgery alone or in combination with medical treatment [17]. Thus, it may also provide clinicians with another tool, apart from GH and IGF-1, to assess disease activity in acromegaly.…”

Section: Discussionsupporting

confidence: 90%

“…Recent data suggest that sKlotho levels are elevated in patients with active acromegaly [14,15]. After surgical removal of the GH-producing pituitary adenoma alone or in combination with first-generation SRLs they decrease toward the normal range [14][15][16][17]. Overall, when assessing patients with acromegaly, concomitant and parallel changes in serum sKlotho and IGF-1 were observed over time in each patient, and levels of sKlotho and IGF-1 appeared to be similarly dependent on GH [14,18].…”

Section: Introductionmentioning

confidence: 96%

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Soluble Klotho: a possible predictor of quality of life in acromegaly patients

et al. 2020

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Purpose Although quality of life (QoL) is improved in patients with acromegaly after disease control, QoL correlates only weakly with traditional biomarkers. Our objective is to investigate a potential relation between the new serum biomarker soluble Klotho (sKlotho), GH and insulin-like growth factor 1 (IGF-1) levels, and QoL. Methods In this prospective cohort study, we investigated 54 acromegaly patients biochemically well-controlled on combination treatment with first-generation somatostatin receptor ligands (SRLs) and pegvisomant (PEGV) at baseline and 9 months after switching to pasireotide LAR (PAS-LAR; either as monotherapy, n = 28; or in combination with PEGV, n = 26). QoL was measured by the Patient-Assessed Acromegaly Symptom Questionnaire (PASQ) and Acromegaly Quality of Life (AcroQoL) questionnaire. Results Switching to PAS-LAR treatment significantly improved QoL without altering IGF-1 levels. QoL did not correlate with GH or IGF-1 levels, but sKlotho correlated with the observed improvements in QoL by the AcroQoL global (r = −0.35, p = 0.012) and physical subdimension (r = −0.34, p = 0.017), and with PASQ headache (r = 0.28, p = 0.048), osteoarthralgia (r = 0.46, p = 0.00080) and soft tissue swelling score (r = 0.29, p = 0.041). Parallel changes in serum sKlotho and IGF-1 (r = 0.31, p = 0.023) suggest sKlotho and IGF-1 to be similarly dependent on GH. Comparing the PAS-LAR combination therapy and the monotherapy group we did not observe a significant difference in improvement of QoL. Conclusions Patients experienced improved QoL during PAS-LAR, either as monotherapy or in combination with PEGV. Soluble Klotho concentrations appear to be a useful marker of QoL in acromegaly patients but the underlying mechanisms remain to be investigated.

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