Slow-release lanreotide in the treatment of acromegaly: a study in 66 patients

被引:48
作者
Verhelst, JA
Pedroncelli, AM
Abs, R
Montini, M
Vandeweghe, M
Albani, G
Maiter, D
Pagani, MD
Legros, JJ
Gianola, D
Bex, M
Poppe, K
Mockel, J
Pagani, G
机构
[1] Middelheim Ziekenhuis Antwerpen, Dept Endocrinol, Antwerp, Belgium
[2] Univ Ziekenhuis Antwerpen, Dept Endocrinol, Antwerp, Belgium
[3] Univ Ziekenhuis Gent, Dept Endocrinol, Ghent, Belgium
[4] Clin Univ St Luc, Dept Endocrinol, B-1200 Brussels, Belgium
[5] Univ Liege, Dept Endocrinol, Liege, Belgium
[6] Univ Ziekenhuis Leuven, Dept Endocrinol, Louvain, Belgium
[7] Free Univ Brussels, Dept Endocrinol, Brussels, Belgium
[8] Osped Riuniti Bergamo, Dept Endocrinol, I-24100 Bergamo, Italy
关键词
D O I
10.1530/eje.0.1430577
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective : Slow-release (SR) lanreotide is a long-acting somatostatin analog that has been developed in order to overcome the inconvenience of multiple daily subcutaneous injections of octreotide, required for metabolic control in acromegaly. Lanreotide SR has been found to be well tolerated and effective in reducing GH and IGF-I levels but clinical data are still limited compared with those with subcutaneous octreotide treatment. Design: Sixty-six unselected patients with active acromegaly were therefore evaluated in a multi-center, prospective, open label study. Lanreotide SR was given at a dose of 30 mg intramuscular every 7-14 days. Methods: At baseline and after 2, 4, 8, 12, 24, 36 and 48 weeks patients underwent a clinical examination with assessment of acromegaly related symptoms, and blood was sampled for serum GH, ICF-I, prolactin, glycosylated hemoglobin fasting glucose, hematology, kidney function and liver function tests. Biliary ultrasonography and pituitary magnetic resonance imaging were performed at baseline and after one year. Results: Treatment resulted in a significant improvement in the symptom score from 2.69 +/- 0.27 to 1.06 +/- 0.17 (P< 0.0001). Serum IGF-I levels fell from 699 +/- 38 <mu>g/l at baseline to 399 +/- 26 mug/l (P<0.0001, n=60) after one month, after which levels remained stable: 480 +/- 37 <mu>g/l after 6 months (n = 54) and 363+/- 32 mug/l after one year (n = 46). GH levels dropped from 13.8 +/- 3.2 mug/l to 4.3+/-0.7 mug/l after one month (P < 0.0001, n= 60) and remained stable thereafter: 3.9+/- 0,4 CLg/l (n=54 ) after 6 months and 3.5 +/- 1.1 <mu>g/l after one year (n= 46). Twenty-nine out of 66 patients (44':%) attained a normal age-corrected IGF-I level and 30 patients (45%) attained a GH level below 2.5 mug/l, Pituitary adenoma shrinkage of at least 25% was found in 5 of 14 patients (3 6%) after one year. Side effects were mainly transient gastrointestinal symptoms and pain at the injection site, resulting in drug discontinuation in only 6 patients (9%). Two patients developed new gall stones. No difference was found between subcutaneous octreotide and lanreotide SR in efficacy and almost all patients preferred the easier dose administration of lanreotide SR. Conclusions: Long-term treatment of acromegaly with SR-lanreotide is effective in controlling GH and ICF-I levels and symptoms and is well tolerated in the majority of patients. Compared with subcutaneous octreotide, lanreotide SR considerably improves patient's acceptance of therapy while having the same overall efficacy.
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收藏
页码:577 / 584
页数:8
相关论文
共 29 条
  • [1] Cabergoline in the treatment of acromegaly: A study in 64 patients
    Abs, R
    Verhelst, J
    Maiter, D
    Van Acker, K
    Nobels, F
    Coolens, JL
    Mahler, C
    Beckers, A
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1998, 83 (02) : 374 - 378
  • [2] The effect of a new slow-release, long-acting somatostatin analogue, lanreotide, in acromegaly
    AlMaskari, M
    Gebbie, J
    KendallTaylor, P
    [J]. CLINICAL ENDOCRINOLOGY, 1996, 45 (04) : 415 - 421
  • [3] BATES AS, 1993, Q J MED, V86, P293
  • [4] INTRAMUSCULAR INJECTIONS OF SLOW-RELEASE LANREOTIDE (BIM-23014) IN ACROMEGALIC PATIENTS PREVIOUSLY TREATED WITH CONTINUOUS SUBCUTANEOUS INFUSION OF OCTREOTIDE (SMS-201-995)
    CARON, P
    COGNE, M
    GUSTHIOTJOUDET, B
    WAKIM, S
    CATUS, F
    BAYARD, F
    [J]. EUROPEAN JOURNAL OF ENDOCRINOLOGY, 1995, 132 (03) : 320 - 325
  • [5] Three year follow-up of acromegalic patients treated with intramuscular slow-release lanreotide
    Caron, P
    MorangeRamos, I
    Cogne, M
    Jaquet, P
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (01) : 18 - 22
  • [6] MEDICAL-TREATMENT OF ACROMEGALY WITH SMS 201-995, A SOMATOSTATIN ANALOG - A COMPARISON WITH BROMOCRIPTINE
    CHIODINI, PG
    COZZI, R
    DALLABONZANA, D
    OPPIZZI, G
    VERDE, G
    PETRONCINI, M
    LIUZZI, A
    DELPOZO, E
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1987, 64 (03) : 447 - 453
  • [7] Effectiveness and tolerability of slow release lanreotide treatment in active acromegaly
    Colao, A
    Marzullo, P
    Ferone, D
    Marinò, V
    Pivonello, R
    Di Somma, C
    Di Sarno, A
    Giaccio, A
    Lombardi, G
    [J]. JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 1999, 22 (01) : 40 - 47
  • [8] RADIATION-THERAPY OF ACROMEGALY
    EASTMAN, RC
    GORDEN, P
    GLATSTEIN, E
    ROTH, J
    [J]. ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA, 1992, 21 (03) : 693 - 712
  • [9] OCTREOTIDE TREATMENT OF ACROMEGALY - A RANDOMIZED, MULTICENTER STUDY
    EZZAT, S
    SNYDER, PJ
    YOUNG, WF
    BOYAJY, LD
    NEWMAN, C
    KLIBANSKI, A
    MOLITCH, ME
    BOYD, AE
    SHEELER, L
    COOK, DM
    MALARKEY, WB
    JACKSON, I
    VANCE, ML
    THORNER, MO
    BARKAN, A
    FROHMAN, LA
    MELMED, S
    [J]. ANNALS OF INTERNAL MEDICINE, 1992, 117 (09) : 711 - 718
  • [10] SURGICAL-MANAGEMENT OF ACROMEGALY
    FAHLBUSCH, R
    HONEGGER, J
    BUCHFELDER, M
    [J]. ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA, 1992, 21 (03) : 669 - 692