Document Detail


Four-year treatment with octreotide-long-acting repeatable in 110 acromegalic patients: predictive value of short-term results?
MedLine Citation:
PMID:  12843148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2003-07-04     Completed Date:  2003-08-08     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:  3090-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Endocrinology, Ospedale Niguarda, I-20162 Milan, Italy. renatocozzi@tiscali.it
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MeSH Terms
Descriptor/Qualifier:
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:
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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