乌鸦传媒

CHICAGO -- New clinical therapies for all types of endocrine disorders were highlighted at ENDO 2018.

Research presented at The Endocrine Society meeting included the benefits of diabetes treatments for obesity, bisphosphonate injection for osteoporosis prevention, metformin for miscarriage-prevention in women with polycystic ovary syndrome (PCOS), and the questionable use of levothyroxine in the elderly.

Bone mineral density (BMD) response was increased with the selective PTH1-receptor activator, abaloparatide-SC (Tymlos), according to results from a phase III study. In the trial done in over 1,100 women, those administered abaloparatide for 18 months, followed by 24 months of alendronate (Fosamax) treatment, had greater increases in BMD versus women given placebo treatment followed by alendronate. Significant improvements were seen in total hip, femoral neck, and lumbar spine BMDs.

In combination with diet and exercise, semaglutide significantly aided in weight lose in people without diabetes. In the 957 people with obesity included in the phase II trial, the greatest weight loss after 52 weeks of treatment was seen in the group receiving 0.4 mg of once-daily subcutaneous semaglutide (-13.8% mean weight loss from baseline). Other doses, including 0.1 mg, 0.2 mg, and 0.3 mg of semaglutide also showed superior weight loss when compared with placebo (-2.3%) and 3 mg of liraglutide (-7.8%).

"This [study] has shown the highest weight reductions yet seen for any pharmaceutical intervention," stated study author Patrick O'Neil, PhD, of the Medical University of South Carolina in Charleston.

For older patients with hypothyroidism, levothyroxine treatment was linked to a significant increase in mortality (HR 1.19 95% CI 1.03-1.38). Congestive heart failure, senile dementia, older age, chronic kidney failure, and cerebrovascular disease were all factors tied to mortality in these patients, although femoral fractures and atrial fibrillation were not.

"Subclinical hypothyroidism ... is very common," stated study author Joseph Meyerovitch, MD, of Schneider Children's Medical Center of Israel, adding "Physicians should consider the results of the study before they begin treatment with levothyroxine in individuals 65 years of age and above who have subclinical hypothyroidism and TSH values under 10 mIU/L."

Among pregnant women with PCOS, metformin treatment from the first trimester through time of delivery was found to reduce the prevalence of late miscarriage and preterm birth compared with placebo (11/211 versus 24/224, P=0.04). These women also tended to gain less weight during the course of the pregnancy, without any impact on infant birth weight or length, throughout the multicenter trial. However, other adverse pregnancy outcomes including gestational diabetes, preeclampsia, and hypertension were not improved with metformin use.

Said investigator Tone Loevvik, MD, of Norwegian University of Science and Technology in Trondheim, "This finding is disappointing, but not surprising. It is in accordance with the from two previous studies from our research group."

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