Drug holiday in patients with polycystic liver disease treated with somatostatin analogues.
| Title: | Drug holiday in patients with polycystic liver disease treated with somatostatin analogues. |
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| Authors: | van Aerts RMM; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.; Kolkman M; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.; Kievit W; Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.; Gevers TJG; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.; Nevens F; Department of Gastroenterology and Hepatology, University Hospital KU Leuven, Belgium.; Drenth JPH; Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands. |
| Source: | Therapeutic advances in gastroenterology [Therap Adv Gastroenterol] 2018 Oct 03; Vol. 11, pp. 1756284818804784. Date of Electronic Publication: 2018 Oct 03 (Print Publication: 2018). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Sage Publications Country of Publication: England NLM ID: 101478893 Publication Model: eCollection Cited Medium: Print ISSN: 1756-283X (Print) Linking ISSN: 1756283X NLM ISO Abbreviation: Therap Adv Gastroenterol Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: London : Sage Publications |
| Abstract: | Background: Somatostatin analogues (SAs) reduce liver volume and relief symptoms in polycystic liver disease (PLD). Its effect wears off after continuing therapy suggesting development of SA tolerance in patients on chronic therapy. We postulate that a drug holiday resensitizes the liver to its acute pharmacological effects. Therefore, this study examines the liver volume-reducing effect of SAs after a drug holiday.; Methods: Patients were identified from the International PLD Registry and included in our analysis when (1) treated with SAs during two cycles separated by a drug holiday and (2) height-adjusted total liver volume (hTLV) was available at start and end of each cycle. For our primary outcome we compared the effect of SAs (in % per 6 months) on hTLV between the first and second treatment cycle.; Results: In 34 patients, initial liver volume-reducing effect was similar to that after rechallenge [-2.6% per 6 months (interquartile range, -3.8-0.8) versus -1.6% per 6 months (interquartile range, -3.1-1.1), p = 0.510]. Cessation of treatment led to a rebound effect, but liver volume remained stable compared with the baseline with intermittent therapy in responders to SA [-0.6% (interquartile range, -7.4-5.7) after 46.5 months].; Conclusions: PLD patients treated with SAs benefit from retreatment after a drug holiday. The significant increase of liver volume after cessation of treatment complicates widespread use of a drug holiday as new treatment strategy. Our results contribute to a better understanding of the pharmacological effect of SAs and help to identify patients who might benefit. |
| Competing Interests: | Conflict of interest statement: J. P. H. Drenth declares associations with the following organizations/companies: Ipsen, Novartis. All other authors declare no competing interests. |
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| Contributed Indexing: | Keywords: drug holiday; liver volume; polycystic liver disease; somatostatin analogues; treatment |
| Entry Date(s): | Date Created: 20181011 Latest Revision: 20230928 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC6172936 |
| DOI: | 10.1177/1756284818804784 |
| PMID: | 30302127 |
| Database: | MEDLINE |
Journal Article