The Efficacy of Sandostatin (Long Acting Release) on Acromegalic Patients: A Study from Northwest Iran

Abstract

Introduction: Acromegaly is a clinical syndrome resulting from excessive secretion of growth hormone with the approximate prevalence of six cases per million. Somatostatin agonists are the only drug approved which can actually control, to some extent, the secretion of growth hormone after surgery. Short-acting analogues of these compounds should be taken three times a day which is very undesirable. In contrast, long-acting analogues of somatostatin have the market availability for more than one decade, but Iranian physicians have the drug accessibility only within the last few years. Aim: To determine the effects of long-acting analogue octreotide (Sandostatin Long Acting Release (LAR) on the level of Growth Hormone (GH), Insulin-like Growth Factor 1 (IGF-1) and clinical symptoms in patients with acromegaly in the northwest of Iran. Materials and Methods: The level of GH, IGF-1 and clinical symptoms were evaluated after long-acting analogue Sandostatin LAR administration in 40 acromegalic patients with no surgical history or any remarkable improvement in clinical features and IGF-1/GH levels after surgery, referred to outpatient endocrinology sections, Tabriz University of Medical Sciences were included. The serum level of GH and IGF-1 were evaluated using electro-chemiluminescence system before and after 3, 6 and 12-months of drug administration. Repeated measure test was used for statistical analysis. p<0.05 was considered as statistically significant. Results: Use of Sandostatin LAR showed 72.5% and 27.5% absolute and partial recovery, respectively. Mean level of IGF-1 before and after 3, 6 and 12-months treatment were 654.17±199.12, 423.95±228.94, 356.22±169.53, 296.25±110.6 μg/L, respectively, (p<0.001). Additionally, Mean GH level before and after 3, 6 and 12-months treatment were 31.71±3.03, 10.31±5.23, 7.28±3.11 and 6.77±4.38 μg/L, respectively, (p<0.001). Conclusion: Sandostatin LAR treatment may be an effective and proper method for treatment of GH producing adenoma in patients who are not good candidates for surgery or having high GH/ IGF-1 levels after surgery.