Endocrine Abstracts

Objective: The aim of this single centre prospective open trial was to evaluate the long-term efficacy of octreotide LAR in acromegaly patients and possibility of withdrawal of this therapy.

Methods: In total 17 patients with acromegaly diagnosed at Endocrinology Clinic in Sarajevo, somatostatin sensitive (ten females and six males, age range 37–65 years, six patients with microadenoma and ten patients with macroadenoma) were treated with octreotide. Follow-up period was 4 years (2009–2014). The concentration of human GH (hGH) and IGF-1 were evaluated every 6 months during follow-up period of 4 years, while magnetic resonance imaging was taken every year during follow-up period.

Results: During the first year of treatment ten patients were included. In the second year a further seven patients were involved. During the fourth year of follow-up, the treatment was successful discontinued at four patient, one patient was died due to co-morbidities and at one another patients treatment was off due to kidney cancer; so currently we followed total of 11 patients. During octreotide treatment significantly reduced GH (50.87±10.56 vs 2±0.36 ng/ml, P<0.005), IGF-1 (777.66±118.40 vs 276±80.54 ng/ml, P<0.005) and adenoma size (from 9.6 to 6 mm; P<0.01). GH decrease to <2.5 ng/ml was achieved in 82% of cases; tumor size decrease was achieved in 60% while normalization of IGF-1 was achieved in 91% of the patients, respectively. At 12–24 months of follow-up, 23.5% of acromegaly patients had withdrawn treatment, without recurrence.

Conclusions: Our findings demonstrated that octreotide LAR treatment is very effective in decrease of GH, IGF-1 and tumor size and it’s withdrawal, though rare, is possible in well-selected acromegalic patients treated for at least 2 years and considered optimally controlled in hormonal and neuroradiological terms.