{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:16:30Z","timestamp":1791908190899,"version":"4.3.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Introduction<\/jats:title>\n Acromegaly is an uncommon disease with important comorbidity and economic cost. Although the pharmacological cost of second-line treatment for refractory acromegaly has been theoretically analyzed, real-life studies are needed.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To assess the use of pasireotide and pegvisomant in a third-level center under routine clinical practice.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Acromegaly patients that had been treated with pasireotide and\/or pegvisomant were included in (A) a cross-sectional study (two years after starting these drugs) to analyze the cost of acromegaly, hormone replacement, and type 2 diabetes mellitus (T2DM) treatments, and the cost of surgery and radiotherapy; and (B) a retrospective cohorts study (May 2006\u2014October 2024) to analyze efficacy, safety (adverse events, fasting glucose, glycated hemoglobin, and T2DM diagnosis), and dose evolution. Descriptive statistics were 10% trimmed means and standard deviation. Two-tailed hypothesis testing with Yuen\u2019s t and Fisher\u2019s test had a\n P<\/jats:italic>\n &lt; 0.05 significance.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 25 participants were included in the transversal study and 31 participants in the longitudinal study. A typical patient with a poorly granulated GH-producing adenoma underwent in-center surgery once and received radiotherapy. In the transversal study, total pharmacological cost was 34,139.29 (13,472.09) \u20ac\/person\/year, with 33,874.88 (13,468.36) \u20ac\/person\/year for second-line acromegaly drugs. Pasireotide displayed 9,423.26 \u20ac\/person\/year worth of savings (\n P<\/jats:italic>\n = .12), reaching 30,415.98 \u20ac\/person\/year at high dose (\n P<\/jats:italic>\n &lt; 0.001). In the longitudinal study, pasireotide dose was reduced (\n P = .<\/jats:italic>\n 06) regardless of treatment modality. Pasireotide affected carbohydrate metabolism (\n P<\/jats:italic>\n = .001), but the effect was generally mild.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Pasireotide was found to be a more cost-effective option in patients with first-line treatment failure.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2025.1573721","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:11:27Z","timestamp":1745799087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Cost-effectiveness analysis of second-line medical therapies in acromegaly: a real-life study"],"prefix":"10.3389","volume":"16","author":[{"given":"Eva","family":"Venegas 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