Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 14 P152

ECE2007 Poster Presentations (1) (659 abstracts)

Evaluation of the efficacy of sandostatin LAR in the treatment of acromegaly

Agata Baldys-Waligorska , Anna Krzentowska , Filip Golkowski & Bohdan Huszno

Department of Endocrinology, Collegium Medicum of the Jagiellonian University, Krakow, Poland.

Background: Somatostatin analogues are used to treat acromegaly patients who, following surgery, have not fulfilled cure criteria (hGH<2,5 ng/ml, IGF-1 below normal range for age and post-OGTT hGH <1,0 ng/ml). We evaluated the efficacy of Sandostatin LAR in managing such patients.

Material and method: In our Clinic, 81 acromegaly patients (mean age 51.6±14.4 yrs) were registered over the years 1983-2005. Based on CT i MRI, macroadenoma and microadenoma were stated in 63% and 37% of these patients, respectively. 70 patients (86.5%) underwent surgery, 6 (7.4%) refused surgery and 5 (6.1%) underwent radiotherapy., Independently of time after surgery, 60 patients underwent diagnostic tests to qualify them for Sandostatin LAR treatment. Treatment efficacy was based on measuring concentration of hGH i IGF-1 3, 6, 9 and 12 months, and performing control MRI 6 and 12 months after the beginning of Sandostatin LAR treatment (20 mg/month, increased to 30 mg/month if unsatisfactory).

Results: Criteria of post-surgery cure were not fulfilled by 40 patients (66.6% of the 60 evaluated). Due to poor tolerance, one patient was treated with Pegvisomant. 19 patients (31.6%) required no further treatment. After 6 months of treatment, hGH<2.5 ng/ml was stated in 63%, and IGF-1 below normal ranges for age in 58.8% of patients, and after 12 months – in 68.4% and 36.8% of patients, respectively. In control MRI, recurrence, correlated with enhanced concentration of IGF-1, was stated in 7 patients (17,5%).

Conclusions: In terms of hGH and IGF-1 levels, satisfactory acromegaly control was obtained in about 40% of patients treated with Sandostatin LAR. This result may be biased by the high number of macroadenoma, and possible non-radical surgery in our patients. Due to evident disparity between 12-month normalization of hGH and of IGF-1 levels, measurements of IGF-1 concentration are of considerable diagnostic value in assessing the activity of acromegaly.

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