Endocrine Abstracts (2006) 11 P179

Improvements for patients and nurses using 2.5 ml prefilled syringes as the vehicle solution for suspension of Sandostatin LAR® microspheres

KT Maher1, WM Drake1, GM Besser2, AB Grossman1, SL Chew1, PJ Jenkins1, LA Kalingag1, FK Fode1, MT O’Sullivan-Hawketts1, DM Walker1 & JP Monson1

1Centre for Clinical Endocrinology, William Harvey Institute, St Bartholomew’s Hospital, London, United Kingdom; 2London Clinic Hospital, Centre for Endocrinology, London, United Kingdom.

The preparation of Sandostatin LAR® injections using a 2 ml ampoule of vehicle solution may be associated with some technical difficulties of administration, with adverse consequences for patients. The development of a 2.5 ml prefilled syringe may alleviate some of these problems. We have compared these two methods of Sandostatin LAR® administration in 17 patients with acromegaly and 5 patients with neuro-endocrine tumours, (6 drug naïve, 13 women, median age 55, range 26 to 83 years). All patients received Sandostatin LAR® by both methods in random allocation on two consecutive months by the same nurse, after which both patient and nurse completed a questionnaire assessing pain/discomfort and convenience of administration respectively. Pain was similar on a self-rating scale for both preparations for drug naïve patients, but was worse with the ampoule vehicle in some patients previously established on therapy, (3/22 reporting pain levels as more severe). Patient waiting time was generally shorter with the prefilled syringe, although difficult to record for all patients. Diluent preparation was generally easier and faster for nurses with the prefilled syringe, (6/22 recorded scores of quite easy with the 2.5 ml prefilled syringe vs. 3/22 with the ampoule, and 11/22 recorded scores of very easy with the prefilled syringe vs.1/22 with the ampoule (P=0.002). Reconstitution and drug administration were no different between preparations. Other clear advantages of the prefilled syringe include less wastage of diluent and less chance of contamination of diluent and scratches by broken glass. However clear volume markings on the prefilled syringe would be a major improvement. We conclude that the 2.5 ml prefilled syringe of Sandostatin LAR® has advantages over conventional diluent in the therapy of neuroendocrine tumours and acromegaly.