Effects on GH/IGF1 hypersecretion and tumor size of long-acting somatostatin analogue (Sandostatin LAR) in patients with untreated acromegaly and in previously treated with surgery and/or radiotherapy
T Hasan1, G Pemovska2, B Jovanovska2 & S Subeska2
Objectives: To comperate the efficacy of sandostatin LAR therapy in patients with untreated acromegaly and in previously treated with surgery and/or radiotherapy.
Material and methods: We studied 16 consecutive patients (seven women and nine men, aged 2971 year). Fourteen patients harboured a macroadenoma and two microadenoma. The study was retrospective examination of untreated and previously treated patients with surgery and/or radiotherapy based on the macedonian acromegaly registry. Six patients had received surgery+radiotherapy and seven patients had received only surgery prior to receiving medical therapy. Three patients due to their co-morbidity were unable to receive surgery and as a primary treatment received sandostatin LAR.
Results: Sandostatine LAR was administered i.m. at a dose 20 mg every 28 days for 6 months. Three patients were inoperable due to severe LVH and received SSA as a first line therapy. This treatment induced a significant decrease of GH (2.1±0.4 ng/ml) and IGF1 (156±6.2 ng/ml) in all 16 patients. After six months of treatment, the percent IGF1 suppression was 74.1±4.5% and serum GH/IGF1 values were normalized in 13 patients. Tumour shrinkage occurred in 18.7% of patients. Among 16 patients two improved glycaemic control based on fasting and postprandial plasma glucose levels.
Conclusion: OCT-LAR is an effective agent in alleviating symptoms, suppressing GH, normalizing IGF1 and inducing tumour shrinkage in many acromegalic patients. Overall, OCT-LAR is well tolerated and should be recommended for nonsurgically cured acromegalics, and also be considered as primary therapy for selected cases, mainly for those with a low probability of surgical cure.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.