Forty Month Follow-Up of Persistent and Difficultly Controlled Acromegalic Patients Treated with Depot Long Acting Somatostatin Analog Octreotide

• Published in: Endocrine Journal 2007, Vol.54(3), pp.459-464
• Main Authors: YETKIN, Demet Ozgil, BOYSAN, Serife Nur, TIRYAKIOGLU, Ozay, YALIN, Ayse Serap, KADIOGLU, Pinar
• Format: Article
• Language: English
• Subjects: Acromegaly; Acromegaly - drug therapy; Acromegaly - surgery; Adenoma - drug therapy; Adenoma - surgery; Adult; Comorbidity; Delayed-Action Preparations - adverse effects; Delayed-Action Preparations - therapeutic use; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Glucose Tolerance Test; Growth Hormone-Secreting Pituitary Adenoma - drug therapy; Growth Hormone-Secreting Pituitary Adenoma - surgery; Human Growth Hormone - blood; Humans; Insulin-Like Growth Factor I - analysis; Long term treatment; Male; Middle Aged; Neoplasm, Residual - drug therapy; Octreotide - administration & dosage; Octreotide - adverse effects; Salvage Therapy; Sandostatin LAR; Somatostatin - analogs & derivatives; Treatment Failure
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.K06-100

The objective of the present study was to investigate the effects of octreotide long acting release (S-LAR) preparation on GH and IGF-1 serum concentrations and pituitary tumor size in patients with persistent and difficultly controlled acromegaly even after adjuvant irradiation and/or dopamine agonists. Thirty-three patients with active acromegaly (26 female and 7 male, mean age; 43.94 ± 14.01 SD years) were included in this study. Patients were evaluated at baseline and at 6, 12, 30 and 40 months for GH, IGF-1, and GH response to OGTT and biliary ultrasonography. Sella MRI was performed at initial and at 40 months. All patients received 20 mg S-LAR. Afterwards, the dosage was titrated to improve individual GH response and reduction of IGF-1 into normal ranges. Basal serum IGF-1 levels decreased from median: 530 μg/l [IQR: 420–600] to 340 μg/l [IQR: 230–460] at 6 months (p = 0.01), to 400 μg/l [IQR: 222.4–600] at 12 months (p = 0.48), to 396 μg/l [IQR: 318–468] at 30 months (p = 0.49), to 482 μg/l [308–580] at 40 months (p = 0.47). Nadir GH levels in OGTT fell from 2.70 ng/ml [IQR: 1.35–6.90] to 1.60 ng/ml [IQR: 0.36–4.10] at 6 months (p = 0.03), to 0.31 ng/ml [IQR: 0.18–0.65] at 12 months (p