Document Detail


Efficacy of the long-acting octreotide formulation (octreotide-LAR) in patients with thyrotropin-secreting pituitary adenomas.
MedLine Citation:
PMID:  11397898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The presence of somatostatin receptors on TSH-secreting pituitary adenomas allows treatment of central hyperthyroidism with somatostatin analogs. Six women and 5 men (mean +/- SEM age, 43 +/- 3 yr) presented TSH-secreting pituitary adenomas (micro, n = 2; macro, n = 9). Seven patients had previously been treated with partial surgical removal (n = 6) and/or external radiation (n = 4) of their adenoma at least 1 yr before the study, whereas 4 patients had not been treated before somatostatin analog therapy. TSH, free T(4), and free T(3) levels were in the normal range during treatment with sc injections (n = 9) or continuous infusion (n = 2) of octreotide (280 +/- 25 microg/day). Mean thyroid hormone levels increased (P < 0.01) after the washout period (34 +/- 6 days). The patients received monthly im injections of 20 mg Octreotide-LAR. In patients with an elevated free T(4) level after 3 months (n = 1) the Octreotide-LAR dose was increased to 30 mg. After 3 months of Octreotide-LAR treatment, TSH, free T(4)/T(3), and alpha-subunit levels decreased, and 10 patients were euthyroid with normal free T(4) levels. These results remained at the same level over the next 3 months. There were no statistically significant differences in the TSH and free T(4) responses to sc octreotide or im Octreotide-LAR between previously untreated patients and patients who had undergone surgical resection and/or pituitary radiation before somatostatin analog treatment. During Octreotide-LAR treatment, minor digestive problems or moderate discomfort at the injection site, lasting less than 48 h, were reported in 6 and 5 patients, respectively. Gallbladder echographies did not reveal new gallstones during Octreotide-LAR treatment. In conclusion, this study shows that monthly im Octreotide-LAR is as effective as daily sc octreotide in controlling hyperthyroidism in patients with TSH-secreting pituitary adenomas, in both previously untreated patients and patients treated with surgery and/or pituitary radiotherapy. Octreotide-LAR is well tolerated, except for minor digestive problems or mild pain at the injection site. Therefore, Octreotide-LAR appears to be a useful therapeutic tool to facilitate medical treatment of TSH-secreting pituitary adenomas in patients who need long-term somatostatin analog therapy.
Authors:
P Caron; S Arlot; C Bauters; P Chanson; J M Kuhn; M Pugeat; R Marechaud; C Teutsch; E Vidal; P Sassano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  86     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-06-08     Completed Date:  2001-07-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2849-53     Citation Subset:  AIM; IM    
Affiliation:
Department of Endocrinology, University Hospital, 31403 Toulouse, France. caron.p@chu-toulouse.fr
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MeSH Terms
Descriptor/Qualifier:
Adenoma / drug therapy*,  secretion*
Adult
Antineoplastic Agents, Hormonal / adverse effects,  therapeutic use*
Cohort Studies
Delayed-Action Preparations
Female
Humans
Injections, Intramuscular
Male
Middle Aged
Octreotide / adverse effects,  therapeutic use*
Pituitary Neoplasms / drug therapy*,  secretion*
Thyrotropin / blood,  secretion*
Thyroxine / blood
Triiodothyronine / blood
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Delayed-Action Preparations; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 83150-76-9/Octreotide; 9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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