Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: a meta-analysis of published observational studies

Stone, Jennifer C., Clark, Justin, Cuneo, Ross, Russell, Anthony W. and Doi, Suhail A. R. (2013) Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: a meta-analysis of published observational studies. Pituitary, Online First 1-12. doi:10.1007/s11102-013-0504-2

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Author Stone, Jennifer C.
Clark, Justin
Cuneo, Ross
Russell, Anthony W.
Doi, Suhail A. R.
Title Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: a meta-analysis of published observational studies
Journal name Pituitary   Check publisher's open access policy
ISSN 1386-341X
1573-7403
Publication date 2013-08-08
Sub-type Article (original research)
DOI 10.1007/s11102-013-0504-2
Open Access Status
Volume Online First
Start page 1
End page 12
Total pages 12
Place of publication New York, NY, United States
Publisher Springer New York
Collection year 2014
Language eng
Formatted abstract
Estrogen and selective estrogen receptor modulator (SERM) treatments for acromegaly have received limited attention since the development of newer pharmacologic therapies. There has been ongoing research evidence suggesting their utility in the biochemical control of acromegaly. Therefore, the aim of this meta-analysis was to synthesise current evidence with a view to determining to what extent and in which acromegalic patient subsets do estrogen and SERMs reduce IGF-1 levels. A literature search was conducted (finished December 2012), which included all studies pertaining to estrogen or SERM treatment and IGF-1. Seven patient subsets were identified from six published observational studies, and were pooled using meta-analytic methods. Overall, the pooled mean loss in IGF-1 was −29.09 nmol/L (95 % CI −37.23 to −20.95). A sensitivity analysis indicated that women receiving estrogen had a substantially greater reduction in IGF-1 levels compared with women receiving SERMs, with a weighted mean loss in IGF-1 of −38.12 nmol/L (95 % CI −46.78 to −29.45) compared with −22.91 nmol/L (95 % CI −32.73 to −13.09). There was a trend that did not reach statistical significance for men receiving SERM treatment at −11.41 nmol/L (95 % CI −30.14 to 7.31). It was concluded that estrogen and SERMs are a low cost and effective treatment to achieve control of IGF-1 levels in acromegalic women either as concomitant treatment for refractory disease, or where access to conventional therapy is restricted. Their use in men requires further study.
Keyword Estrogen
SERM
Acromegaly
IGF-1
Meta-analysis
Systematic review
Selective estrogen receptor modulators
SERMs
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 08 August 2013

 
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Created: Mon, 25 Nov 2013, 15:27:21 EST by Justin M Clark on behalf of Research Computing Centre