Efficacy of Octreotide LAR in Acromegalic Patients

Abstract

Background: Octreotide (OC)-LAR is a long-acting preparation of octreotide which has been effectively used to suppress GH/IGF-1 hypersecretion in acromegalic patients. The clinical response, biochemical outcomes, and safety of OC-LAR were evaluated in 27 active acromegalic patients. Method: 27 patients with an active disease status (according to the clinical picture, GH >5 μg/L and elevated age-matched IGF-1), and previously treated with bromocriptine after surgery, comprised the study population. OC-LAR was given (20 mg, i.m., every 4 week for 3 injections, then the doses were titrated individually) and the acromegalic symptoms and adverse reactions recorded. The serum levels of GH and IGF-1 were evaluated every 12 week. The acromegalic symptoms including headache, fatigue and arthralgia, improved in all patients. Results: Gastrointestinal side effects were transient and mild. The levels of GH significantly decreased, from 8.9 ± 3.5 to 2.9 ± 2.2 μg/L at 12 weeks (P < 0.001, vs. baseline), to 2.9 ± 2.1 μg/L after 24 weeks (P < 0.001) and to 2.5 ± 1.3 μg/L at 48 weeks (P < 0.001). The levels of IGF-1 significantly decreased, from 753.7 ± 213.6 to 429.7 ± 253.4 μg/L at 12 weeks (P < 0.001, vs. at baseline), to 405.7 ± 213.3 μg/L at 24 weeks (P < 0.001) and to 348.9 ± 144.7 μg/L at 48 weeks (P <0.001). The safelevel of GH is less than 2.5 μg/L and normal age-matched IGF-1 levels were achieved in 63 and 52% of the patients, respectively. Conclusion: Octreotide-LAR was well tolerated and effective as an adjuvant treatment in lowering the levels of GH and IGF-1 in active acromegalic patients (J Kor Soc Endocrinol 20:344～352, 2005).