| Four-year treatment with octreotide-long-acting repeatable in 110 acromegalic patients: predictive value of short-term results? | |
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MedLine Citation:
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PMID: 12843148 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effects of a very prolonged treatment with octreotide (OC)-long-acting repeatable (LAR) were retrospectively evaluated in 110 patients with acromegaly, showing a GH/IGF-I decrease of at least 20% vs. baseline after a short-term (6-month) OC-LAR challenge. OC-LAR was given (20 mg, im, every 28 d for 3 injections, then individually tailored) as adjuvant treatment (AT) in 59. The other 51 [primary treatment (PT)] were naive or previously treated by pharmacotherapy. IGF-I normalized in 83 patients [75%; from 770 +/- 26 (mean +/- SE) to 276 +/- 15 micro g/liter; P < 0.0001; median follow-up, 30 months; range, 18-54 months). A progressive increase in the rate of IGF-I normalization was observed. GH fell to less than 2.5 micro g/liter in 72% and to less than 1 micro g/liter in 27% (from 20.7 +/- 2.4 to 2.2 +/- 0.2 micro g/liter; P < 0.0001). PT and AT patients achieved similar final GH/IGF-I levels and rates of normalization. Patients attaining safe GH and normal IGF-I had GH levels below 5 micro g/liter after 3 months and IGF-I levels below 550 micro g/liter after 6 months. No tachyphylaxis was observed. The up-titration to 30 mg improved IGF-I suppression. Elderly patients had greater sensitivity. Tumor shrank in 46% of assessable patients, in 77% of PT patients, and in 91% of naive patients. The powerful suppression of GH/IGF-I levels without tachyphylaxis, the finding of progressive increase in the rate of IGF-I normalization and of superimposable effects in PT and AT patients, and the predictive value of short-term results support the role of PT of acromegaly with OC-LAR in at least some patients. |
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Authors:
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Renato Cozzi; Roberto Attanasio; Marcella Montini; Giorgio Pagani; Giovanni Lasio; Sandro Lodrini; Michela Barausse; Mascia Albizzi; Daniela Dallabonzana; Alberto M Pedroncelli |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of clinical endocrinology and metabolism Volume: 88 ISSN: 0021-972X ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-07-04 Completed Date: 2003-08-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
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Languages: eng Pagination: 3090-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Endocrinology, Ospedale Niguarda, I-20162 Milan, Italy. renatocozzi@tiscali.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acromegaly
/
blood,
drug therapy* Adult Aged Aged, 80 and over Female Follow-Up Studies Hormones / administration & dosage*, adverse effects Human Growth Hormone / blood Humans Insulin-Like Growth Factor I / metabolism Male Middle Aged Octreotide / administration & dosage*, adverse effects Pituitary Neoplasms / blood, drug therapy Predictive Value of Tests Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Hormones; 12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I; 83150-76-9/Octreotide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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