Document Detail


The treatment of de novo acromegalic patients with octreotide-LAR: efficacy, tolerability and cardiovascular effects.
MedLine Citation:
PMID:  14674719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Somatostatin analogues are normally used as adjunctive therapy to surgery and radiotherapy in management of acromegaly. We studied the effects of de novo OCT-LAR treatment on growth hormone (GH) suppression, tumour size, cardiovascular function, clinical symptoms, signs and quality of life in 9 newly diagnosed acromegalic patients. METHODS: Patients commenced OCT-LAR 20 mg IM monthly for 2 months. Dose increased to 30 mg monthly if mean serum GH (MGH) > 5 mU/l (2 microg/litre) (7 patients). Treatment continued for 6 months. Cardiac function assessed by echocardiography at baseline and day 169. Left ventricular (LV) mass and ejection fraction (EF) calculated from 2D M-mode studies. RESULTS: Serum GH demonstrated suppression in 8/9 patients (mean suppression 64.9% +/- 29.7%, range; 4-95.2%). MGH suppressed < 5 mU/ (2 microg/litre) in 3 (33%) patients. IGF-I and IGFBP3 normalised in 1 (12.5%) and 3 (38%) patients respectively. Tumour shrinkage seen in 30% patients. Eight patients were assessed by echocardiography. At baseline, 7 patients demonstrated abnormalities in LV mass and EF. At day 169, 6 patients demonstrated a fall and 1 an increase in LV mass. Overall there was no significant change in LV mass. A significant increase in EF was observed (p = 0.02). There were significant improvements in health perception (p = 0.01), fatigue (p < 0.05) and perspiration (p = 0.0039). CONCLUSIONS: These data demonstrate OCT-LAR provides adequate control of acromegaly in a proportion of patients treated over 6 months. This is associated with improved LV function, evidenced by increased EF. Improved results are expected with longer-term treatment. OCT-LAR may be considered as primary treatment for acromegaly in selected patients.
Authors:
J Gilbert; M Ketchen; P Kane; T Mason; E Baister; M Monaghan; S Barr; P E Harris
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pituitary     Volume:  6     ISSN:  1386-341X     ISO Abbreviation:  Pituitary     Publication Date:  2003  
Date Detail:
Created Date:  2003-12-16     Completed Date:  2004-07-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-8     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, King's College Hospital, Bessemer Rd, London SE5 9RS.
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / drug therapy*
Adenoma / drug therapy*
Adult
Aged
Antineoplastic Agents, Hormonal / administration & dosage*
Female
Humans
Insulin-Like Growth Factor Binding Protein 3 / blood
Insulin-Like Growth Factor I / metabolism
Male
Middle Aged
Octreotide / administration & dosage*
Pituitary Neoplasms / drug therapy*
Prospective Studies
Stroke Volume / drug effects
Treatment Outcome
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Insulin-Like Growth Factor Binding Protein 3; 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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