Oktreotid-depot therapy of acromegaly with long action somatostatin analogue
Julia Pokramovich1, Alexandr Dreval1, Olga Nechaeva1, Viacheslav Pronin1,2, Dmitry Koloda1,2 & Evgeny Gitel1,2
Aim: To estimate efficiency of long acting somatostatin analog (Oktreotid-Depot, Ltd FarmSyntez, Russia) in acromegaly treatment.
Material and methods: Twenty-five patients with the confirmed acromegaly diagnosis, active phase, receiving Oktreotid-Depot therapy within 612 months in a single dose of 2040 mg/month. Every three months dynamics of clinical signs, basal IGF-1 and GH levels and pituitary adenoma size were analyzed.
Results: The most pronounced and significant (P<0.0001) decrease in clinical and laboratory acromegaly signs was observed in first three months of treatment: GH from 18.1 (7.7; 3.3) to 4.2 (1.9; 13.5) mU/l, IGF-1 from 566 (445; 813) to 235 (188; 391) ng/ml. By third month of Oktreotid-Depot therapy, IGF-1 normalisation was observed in 52% patients, by sixth month in 32%, to the ninth in 40%, to the twelfth in 53% patients. In all patients with normalised IGF-1 level basal GH level was normal (<2.5 ng/ml) too. In group of patients with normalised IGF-1 level by third month, its normal values were supported till the end of the period of supervision in the majority of patients. In other patients the incidental deviation from norm was insignificant usually no more than 10%. In patients with elevated IGF-1 level in 3 months its decrease was more than 50% and remains at the reached level within 12 months.
Before Octreotid-Depo treatment the median macroadenomas size was 2.3 (1.1; 4.85) cm3 and in 6 months therapy it decreased to 1.4 (0.75; 4.6) cm3. In three of eight patients a reduction of the adenoma size was significant: 21, 39.2, and 74%. In four patients in 6 months of treatment a stabilisation tumour sizes was marked.
Conclusion: Oktreotid-Depot an effective medication for acromegaly treatment in active phase which in some cases causes reduction of tumour size.