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2008, Number 6

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Rev Med Inst Mex Seguro Soc 2008; 46 (6)

Treatment of Acromegaly with Octreotide LAR

Sosa E, Espinosade-los-Monteros AL, González B, Vargas G, Mier F, Mercado M

Language: Spanish
References: 29
Page: 651-658
PDF size: 126.39 Kb.


ABSTRACT

Background: treatment of acromegaly with somastostatin analogues, albeit highly effective, is not curative and its elevated cost represents a major disadvantage. Hereby we describe our Center’s experience using a fixed, 20 mg q.4 weeks- dose of octreotide LAR.
Methods: 97 patients, 69 females, 71 with macroadenomas, treated with 20-mg im injections of octreotide LAR every 4 weeks, in 23 as primary therapy. No dose escalation was allowed. Patients were evaluated with GH and IGF-1 levels at 4 weeks after the third injection; thereafter, assessments occurred at 3 to 6 months intervals. In 27 unselected patients, evaluations were also performed 6 weeks after the SA injection.
Results: a GH concentration ‹ 2.5 ng/mL was reached by 71%, 75% and 83% of patients at the 3rd, 6th and 12th months of follow up respectively, whereas over 30% achieved an IGF-1 index ≤ 1.0 at each of these time points, and both biochemical goals were achieved by 30%, 33% and 32% of patients at the same time points. Biochemical success was the same for those patients treated primarily and those treated secondarily and prior radiation made no difference. A baseline GH level › 10 ng/mL was associated with a poor response.
Conclusions: a biochemical control rate comparable with other published series it is feasible to reach with the treatment with a fixed dose of 20 mg.


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