Aim: To investigate the efficacy of octreotide LAR therapy in acromegalic patients as primary or secondary therapy.
Methods: Ten acromegalic patients diagnosed at Clinic of Endocrinology in Sarajevo (seven females and three males, mean age 55.2±7.2 years, age range 4065 years, five patients with microadenoma and five patients with macroadenoma) were treated with octreotideLAR. Operated were 60% of patients. Concentration of hGH and IGF1 was evaluated at 0, 6 and 12 months, while MRI images were taken at 0 and 12 months. All patients had active acromegaly. Somatostatin suppression tests were done before octreotide were given. At our center, this is first time to use OctreotideLAR in acromegaly treatment. Eight patients received SandostatinLAR 30 mg/28 days, one patient received 20 mg and one 60 mg/28 days. Normal IGF1 concentrations for age and sex and a GH <2.5 ng/ml were defined as biochemical control. Basic statistics were applied.
Results: Before treatment GH were 50.13±22.44 ng/ml (range: 19105), IGF1 were 753.66±103.48 ng/ml (range: 542896). Four patients (40%) were followed with primary octreotideLAR treatment. After 6 and 12 months the hGH decreased to 2.74±1.70 ng/ml (range: 1.37.0) and 1.86±0.56 ng/ml (range: 1.03.0) respectively, while the IGF1 became 345.33±73.33 ng/ml (range: 265489) and 254.10±23.08 ng/ml (range: 210289) respectively. Prior to treatment the size of pituitary adenomas was 9.57 mm (min 3.0; max 20), while after 12 months of treatment, the size decreases to 8.0 mm (min 1.0; max 18.0). After therapy, decrease of GH below 2.5 ng/ml were achieved in 90% patients, decrease of the tumor size were achieved in 60% while normalization of IGF1 were achieved in 100% of the patients respectively. One of patients with macroadenoma was used 60 mg octreotideLAR as secondary therapy after surgical treatment, because a dose of 30 mg was not enough for decrease of GH and IGF1. All differences were statistically significant (P<0.05), but in group of acromegalic patients treated with octreotideLAR as primary therapy that difference was more significant.
Conclusions: OctreotideLAR treatment of acromegalic patients not only decreases hGH and IGF1 concentrations, but also appears to diminish a size of the tumour, in about 60% of patients. The somatostatin analogues are more efficient in primary treatment of acromegalic patients.
30 Apr - 04 May 2011
European Society of Endocrinology