Document Detail


Pasireotide (SOM230) demonstrates efficacy and safety in patients with acromegaly: a randomized, multicenter, phase II trial.
MedLine Citation:
PMID:  20410233     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Pasireotide (SOM230) is a novel multireceptor ligand somatostatin analog with affinity for somatostatin receptor subtypes sst(1-3) and sst(5). Because most GH-secreting pituitary adenomas express sst(2) and sst(5), pasireotide has the potential to be more effective than the sst(2)-preferential somatostatin analogs octreotide and lanreotide. OBJECTIVE: Our objective was to evaluate the efficacy and safety of three different doses of pasireotide in patients with acromegaly. DESIGN: We conducted a phase II, randomized, multicenter, open-label, three-way, crossover study. PATIENTS: Sixty patients with acromegaly, defined by a 2-h five-point mean GH level higher than 5 microg/liter, lack of suppression of GH to less than 1 microg/liter after oral glucose tolerance test, and elevated IGF-I for age- and sex-matched controls. Patients could have had previous surgery, radiotherapy, and/or medical therapy or no previous treatment. INTERVENTION: After treatment with octreotide 100 microg s.c. three times daily for 28 d, each patient received pasireotide 200, 400, and 600 microg s.c. twice daily in random order for 28 d. MAIN OUTCOME MEASURE: A biochemical response was defined as a reduction in GH to no more than 2.5 microg/liter and normalization of IGF-I to age- and sex-matched controls. RESULTS: After 4 wk of octreotide, 9% of patients achieved a biochemical response. After 4 wk of pasireotide 200-600 microg s.c. bid, 19% of patients achieved a biochemical response, which increased to 27% after 3 months of pasireotide; 39% of patients had a more than 20% reduction in pituitary tumor volume. Pasireotide was generally well tolerated. CONCLUSIONS: Pasireotide is a promising treatment for acromegaly. Larger studies of longer duration evaluating the efficacy and safety of pasireotide in patients with acromegaly are ongoing.
Authors:
S Petersenn; J Schopohl; A Barkan; P Mohideen; A Colao; R Abs; A Buchelt; Y-Y Ho; K Hu; A J Farrall; S Melmed; B M K Biller;
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Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-04-21
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  95     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-07     Completed Date:  2010-07-01     Revised Date:  2010-08-02    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2781-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Endocrinology, Medical Center, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. stephan.petersenn@uni-due.de
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00088582
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / drug therapy*
Adolescent
Adult
Aged
Aged, 80 and over
Blood Glucose / metabolism
Cross-Over Studies
Dose-Response Relationship, Drug
Double-Blind Method
Endpoint Determination
Female
Human Growth Hormone / blood
Humans
Insulin-Like Growth Factor I / metabolism
Magnetic Resonance Imaging
Male
Middle Aged
Octreotide / adverse effects,  therapeutic use
Pituitary Neoplasms / pathology
Somatostatin / adverse effects,  analogs & derivatives*,  pharmacokinetics,  therapeutic use
Young Adult
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/pasireotide; 12629-01-5/Human Growth Hormone; 51110-01-1/Somatostatin; 67763-96-6/Insulin-Like Growth Factor I; 83150-76-9/Octreotide
Investigator
Investigator/Affiliation:
Thierry Brue / ; Philippe Caron / ; Phillipe Chanson / ; Ross Cuneo / ; Angel Díaz / ; Ezio Ghigo / ; Rolf Gaillard / ; Irene Halperin / ; David Kleinberg / ; Vincent Rohmer / ; J A Romijn / ; Jean-Louis Schlienger / ; Paul Stewart / ; Antoine Tabarin / ; Peter J Trainer / ; A J van der Lely / ; Mary Lee Vance /
Comments/Corrections
Comment In:
Nat Rev Endocrinol. 2010 Aug;6(8):417

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


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