Document Detail


Limited predictive value of an acute test with subcutaneous octreotide for long-term IGF-I normalization with Sandostatin LAR in acromegaly.
MedLine Citation:
PMID:  15994747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study whether the growth hormone (GH) response after the subcutaneous administration 50 microg of octreotide (acute octreotide test) has any predictive value for long-term IGF-I normalization with Sandostatin LAR. DESIGN: Twenty four therapy-naive patients with active acromegaly were studied. RESULTS: > 75% GH decrease in the acute octreotide test predicted long-term IGF-I normalization with Sandostatin LAR in 8/11 (73%) of patients. 3/13 (23%) patients with < 75% GH decrease in the acute octreotide test were long-term biochemically controlled with Sandostatin LAR. Using the > 75% GH reduction criterion, the sensitivity and specificity of this test for predicting long-term normalization of serum IGF-I with Sandostatin LAR treatment were 73% and 77%, respectively (positive and negative predictive values: 73% and 77%, respectively). 6/8 (75%) patients with GH suppression to levels < 1.1 microg/l and 9/16 (56%) patients with GH suppression to levels < 2 microg/l in the acute octreotide test showed normalization of serum IGF-I with long-term Sandostatin LAR treatment. The sensitivity and specificity of GH suppression < 1.1 microg/l for predicting of the long-term normalization of serum IGF-I with Sandostatin LAR therapy were 55% and 85%, respectively (positive and negative predictive values: 75% and 69%, respectively). The sensitivity and specificity of GH suppression < 2 microg/l for predicting of the long-term normalization of serum IGF-I with Sandostatin LAR therapy were 82% and 46%, respectively (positive and negative predictive values: 56% and 75%, respectively). CONCLUSION: The acute octreotide is not recommended for clinical decision making with regard to long-term treatment using the long-acting somatostatin analog Sandostatin LAR in acromegaly.
Authors:
Wouter W de Herder; H Rob Taal; Piet Uitterlinden; Richard A Feelders; Joop A M J L Janssen; Aart-Jan van der Lely
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  153     ISSN:  0804-4643     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  67-71     Citation Subset:  IM    
Affiliation:
Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. w.w.deherder@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / blood,  drug therapy*
Adult
Aged
Antineoplastic Agents, Hormonal / administration & dosage*,  diagnostic use
Decision Making
Female
Follow-Up Studies
Human Growth Hormone / blood
Humans
Injections, Subcutaneous
Insulin-Like Growth Factor I / metabolism*
Male
Middle Aged
Octreotide / administration & dosage*,  diagnostic use
Predictive Value of Tests
Prognosis
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 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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