title: Pasireotide Long-Acting Release Treatment for Diabetic Cats with Underlying Hypersomatotropism.
abstract: BACKGROUND
  Long-term medical management of hypersomatotropism (HS) in cats has proved unrewarding. Pasireotide, a novel somatostatin analogue, decreases serum insulin-like growth factor 1 (IGF-1) and improves insulin sensitivity in cats with HS when administered as a short-acting preparation.
  
  
  OBJECTIVE
  Assess once-monthly administration of long-acting pasireotide (pasireotide LAR) for treatment of cats with HS.
  
  
  METHODS
  Fourteen cats with HS, diagnosed based on diabetes mellitus, pituitary enlargement, and serum IGF-1 > 1000 ng/mL.
  
  
  METHODS
  Uncontrolled, prospective cohort study. Cats received pasireotide LAR (6-8 mg/kg SC) once monthly for 6 months. Fructosamine and IGF-1 concentrations, and 12-hour blood glucose curves (BGCs) were assessed at baseline and then monthly. Product of fructosamine concentration and insulin dose was calculated as an indicator of insulin resistance (Insulin Resistance Index). Linear mixed-effects modeling assessed for significant change in fructosamine, IGF-1, mean blood glucose (MBG) of BGCs, insulin dose (U/kg) and Insulin Resistance Index.
  
  
  RESULTS
  Eight cats completed the trial. Three cats entered diabetic remission. Median IGF-1 (baseline: 1962 ng/mL [range 1051-2000 ng/mL]; month 6: 1253 ng/mL [524-1987 ng/mL]; P < .001) and median Insulin Resistance Index (baseline: 812 μmolU/L kg [173-3565 μmolU/L kg]; month 6: 135 μmolU/L kg [0-443 μmolU/L kg]; P = .001) decreased significantly. No significant change was found in mean fructosamine (baseline: 494 ± 127 μmol/L; month 6: 319 ± 113.3 μmol/L; P = .07) or MBG (baseline: 347.7 ± 111.0 mg/dL; month 6: 319.5 ± 113.3 mg/dL; P = .11), despite a significant decrease in median insulin dose (baseline: 1.5 [0.4-5.2] U/kg; 6 months: 0.3 [0.0-1.4] U/kg; P < .001). Adverse events included diarrhea (n = 11), hypoglycemia (n = 5), and worsening polyphagia (n = 2).
  
  
  CONCLUSIONS
  Pasireotide LAR is the first drug to show potential as a long-term management option for cats with HS.
authors.affiliation: Diabetic Remission Clinic, Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.
authors.forename: R
authors.initials: R
authors.lastname: Gostelow
authors.affiliation: Diabetic Remission Clinic, Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.
authors.forename: C
authors.initials: C
authors.lastname: Scudder
authors.affiliation: Diabetic Remission Clinic, Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.
authors.forename: S
authors.initials: S
authors.lastname: Keyte
authors.affiliation: Diabetic Remission Clinic, Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Forcada
authors.affiliation: Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Fowkes
authors.affiliation: Novartis Institutes for Biomedical Research, Oncology Research, Novartis Pharma AG, Basel, Switzerland.
authors.forename: H A
authors.initials: HA
authors.lastname: Schmid
authors.affiliation: Diabetic Remission Clinic, Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.
authors.forename: D B
authors.initials: DB
authors.lastname: Church
authors.affiliation: Diabetic Remission Clinic, Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.|Newcastle Medical School, Newcastle upon Tyne, UK.
authors.forename: S J M
authors.initials: SJ
authors.lastname: Niessen
mesh_terms: D000172:Acromegaly / Q000188:drug therapy / Q000662:veterinary*; D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D002371:Cat Diseases / Q000188:drug therapy*; D002415:Cats; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000662:veterinary*; D005260:Female; D019270:Fructosamine / Q000097:blood; D006728:Hormones / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D011446:Prospective Studies; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D001786:Blood Glucose; D003692:Delayed-Action Preparations; D006728:Hormones; D007328:Insulin; D019270:Fructosamine; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; C517782:pasireotide
keywords: Acromegaly; Cat; SOM230; Somatostatin