Long-term treatment of acromegaly with octreotide (Sandostatin).
Sixteen patients with acromegaly have been treated with octreotide [100 micrograms twice daily to 200 micrograms 3 times daily according to growth hormone (GH) response] for between 3 and 44 months. The mean serum GH concentrations fell from 39.3 mU/l before treatment to 10.5 mU/l on day 1 of treatment and, with continued treatment (and higher doses in 8 of 16 patients), to 7.9 mU/l. In 2 patients there was no GH suppression. GH suppression after the first administration of octreotide appeared to predict long-term response. Pre-treatment serum insulin-like growth factor 1 levels were elevated in 11 of 12 patients investigated, but were normalized on continued octreotide therapy in 10 of 12. Octreotide suppressed prolactin secretion in all 6 hyperprolactinaemic patients. Steatorrhoea occurred in 15 of 16 patients at initiation of treatment, but resolved in all within 7 days. Two patients developed gallstones. In summary, octreotide is a safe and effective treatment for acromegaly, producing clinical and biochemical improvement in up to 90% of patients. Octreotide is a valuable adjunctive treatment where surgery has failed and also in those with contra-indications to surgery.
Page
M D
MD
Department of Medicine, University of Wales College of Medicine, Cardiff, UK.
Millward
M E
ME
Hourihan
M
M
Hall
R
R
Scanlon
N F
NF
D000172:Acromegaly / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000150:complications; D011388:Prolactin / Q000097:blood; D013961:Thyroid Gland / Q000187:drug effects; D013972:Thyrotropin / Q000096:biosynthesis; D013974:Thyroxine / Q000096:biosynthesis
D001786:Blood Glucose; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D011388:Prolactin; D013972:Thyrotropin; D013006:Growth Hormone; D013974:Thyroxine; D015282:Octreotide