Continuous infusion of octreotide in acromegaly.
15 patients with acromegaly were treated with continuous subcutaneous infusion of octreotide in increasing dose from 200 to 1600 micrograms per 24 h by 200 micrograms increments each week. Patients were studied during the initial 7 h of infusion, weekly at each dose level, then after 1 and 2 months at maximum dosage. 13 patients responded well, as judged by growth hormone (GH) suppression and return of insulin-like growth factor 1 to normal, although 1 patient withdrew due to adverse effects; 2 patients showed no significant reduction in GH. In the 12 responders GH level fell within the first 3 h of infusion at a mean plasma octreotide level of 0.76 (SE 0.26) micrograms/l, corresponding to 25 micrograms of infused drug. Optimum suppression of GH occurred at a dosage of 600 micrograms per 24 h, a plasma drug level of 3.5 (0.5) micrograms/l. A definite reduction in tumour size was seen on computerised tomographic scan in 2 patients. All responders noted subjective improvement in acromegalic symptoms. Adverse effects comprised gastrointestinal disturbances, which were transient and mild in 14 patients but severe in 1; biliary sludging occurred in 1 patient. No significant deterioration in carbohydrate tolerance was seen in the responders.
James
R A
RA
Royal Victoria Infirmary, Newcastle upon Tyne.
Chatterjee
S
S
White
M C
MC
Hall
K
K
Moller
N
N
Kendall-Taylor
P
P
D000172:Acromegaly / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D005947:Glucose / Q000008:administration & dosage; D013006:Growth Hormone / Q000032:analysis; D006801:Humans; D007260:Infusion Pumps; D007279:Injections, Subcutaneous; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010902:Pituitary Gland / Q000000981:diagnostic imaging; D011859:Radiography
D001786:Blood Glucose; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D005947:Glucose; D015282:Octreotide