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Erschienen in:
01.06.2015
Octreotide LAR treatment of acromegaly in “real life”: long-term outcome at a tertiary care center
Erschienen in: Pituitary | Ausgabe 3/2015
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Objective
To report our day-to day experience with the long-term use of octreotide LAR in the treatment of acromegaly.
Patients and methods
Patients with acromegaly managed between 2003 and 2012 with octreotide LAR for a median of 27 months (interquartile ranges 12–60) and who had not received radiation therapy or concomitant treatment with cabergoline were retrospectively evaluated. Both primarily treated patients (n = 33) and patients who received octreotide after failed pituitary surgery (adjunctive treatment, n = 124) were included. Full biochemical response was defined as the achievement of a GH <2.5 ng/mL and an IGF-1 <1.2 times the upper limit of normal (× ULN); we also evaluated efficacy using a GH cut off of <1 ng/mL.
Results
Over 60 % of the patients achieved a GH of <2.5 ng/mL. The combined GH (<2.5 ng/mL) and IGF-1 (<1.2 × ULN) target was achieved by 35.5 and 33.6 % of the patients treated primarily and adjunctively, respectively; these figures dropped to 22.6 and 23 % when using a GH target of <1 ng/mL. All patients reported a significant improvement in acromegalic symptoms. Lower pretreatment GH and IGF-1 levels were both associated with a higher probability of achieving the composite biochemical target.
Conclusion
Currently recommended GH and IGF-1 targets are reached by <36 % of patients treated with octreotide LAR in a day-to day practice context. Nevertheless, in most instances a clinical benefit and an improvement in biochemical markers can be clearly documented.