Abstract
ObjectiveThe introduction of ready-to-use lanreotide Autogel® has presented the possibility of patients receiving their acromegaly treatment at home. The objective of this study was to assess the ability of patients (or their partners) to administer repeat, unsupervised, injections of lanreotide Autogel without compromising efficacy or safety.DesignMulticentre (10 UK regional endocrine centres), open-label, nonrandomised, controlled study. Patients elected either to receive/administer unsupervised home injections after injection technique training (Test group) or continued to receive injections from a healthcare professional (Control group). Patients received monthly injections of lanreotide Autogel® at their established dose. Effects were monitored for up to 40 weeks.PatientsThirty patients (15 per treatment group) with acromegaly treated with a stable dose of lanreotide Autogel® (60, 90 or 120 mg) for ≥ 4 months before screening.MeasurementsThe main outcome measure was the proportion of patients/partners who successfully administered injections throughout the study.ResultsAll Test group patients/partners qualified to administer injections. Fourteen of 15 patients fulfilled all criteria for successful administration of unsupervised injections (95% confidence interval, 70%–99%). Fourteen of 15 Test and 14/15 Control patients maintained growth hormone and IGF-1 control. Local injection tolerability was good for both treatment groups, and safety profiles were similar. All Test group patients continued with unsupervised injections after the study.ConclusionsPatients with acromegaly or their partners were able to administer lanreotide Autogel® injections with no detrimental effect on efficacy and safety; therefore, unsupervised home injections are a viable alternative to healthcare professional injections for suitably motivated patients.
Highlights
The introduction of somatostatin analogues was a major therapeutic advance in the management of acromegaly
Local injection tolerability was good for both treatment groups, and safety profiles were similar
All Test group patients continued with unsupervised injections after the study
Summary
The introduction of somatostatin analogues was a major therapeutic advance in the management of acromegaly. Slow-release, long-acting formulations, administered by fortnightly or monthly injections, have been found to control plasma GH levels, normalize serum levels of IGF-1 and reduce clinical symptoms in over 50% of patients.[1]. Lanreotide Autogel® (Ipsen Pharma Biotech SAS, Signes, France) is a long-acting viscous aqueous formulation of lanreotide, which is supplied in ready-to-use prefilled syringes intended for deep subcutaneous injection. Lanreotide Autogel® provides consistent drug release and is effective in controlling the biochemical markers and symptoms of acromegaly when injected every 28 days[1,2,3,4,5,6,7,8]. The availability of a ready-to-use preparation has raised the possibility of home administration by the patient or a trusted relative Lanreotide Autogel® does not require reconstitution, a process which can be problematic and cause administration problems due to needle blockage by microparticles.
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