Medical treatment of acromegaly with SMS 201-995, a somatostatin analog: a comparison with bromocriptine.
We studied the effects of acute and chronic sc administration of SMS 201-995 (SMS), a long-acting somatostatin analog, in acromegalic patients. The results were compared with those obtained in the same patients treated with oral bromocriptine (Brc). A single dose of 50 micrograms SMS administered to 28 patients induced a more rapid, greater, and more prolonged reduction in plasma GH levels than did 2.5 mg Brc. Chronic treatment [60-330 days; mean 208 +/- 23 (+/- SEM)] with SMS (100-300 micrograms/day) induced in 16 patients a significantly greater decrease in mean plasma GH and somatomedin-C levels than did 20 mg Brc. Combined treatment with the 2 agents had an additional effect. The clinical and metabolic parameters of acromegaly dramatically improved in all patients whose plasma GH and somatomedin-C levels decreased even if they were not normalized by SMS. Reduction in tumor size occurred in 3 of the 10 patients examined by computed tomography before and during SMS treatment. We conclude that SMS is more effective than Brc and that the 2 drugs may be complementary in the medical treatment of acromegaly.
D000172:Acromegaly / Q000097:blood / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D001971:Bromocriptine / Q000627:therapeutic use*; D005260:Female; D013006:Growth Hormone / Q000097:blood; D013007:Growth Hormone-Releasing Hormone; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000097:blood; D008297:Male; D008875:Middle Aged; D015282:Octreotide; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D001971:Bromocriptine; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone; D015282:Octreotide