An audit of long-term octreotide therapy for acromegaly.
BACKGROUND
Octreotide has been successfully used for the treatment of acromegaly, but little long-term data are available.


OBJECTIVE
To determine the long-term efficacy and safety of octreotide in the treatment of acromegaly.


METHODS
Twenty-seven patients with acromegaly were treated with octreotide in a non randomised study. Six patients had not had previous surgery or radiotherapy, and were treated with octreotide alone. Symptoms of acromegaly, IGF-I levels, growth hormone suppression by glucose, pituitary tumour size, and side effects were monitored. The median duration of treatment was 44 months (range six-102).


RESULTS
Symptom control was excellent. Twenty (74%) patients had a reduction of IGF-I into the normal range. IGF-I levels fell after one year from 94.2 +/- 6.1 nmol/L (mean +/- SEM) to 50.0 +/- 2.7 nmol/L (p < 0.0001). Ten of 13 (77%) patients had normal IGF-I levels after four years. These reductions have persisted for up to nine years of octreotide therapy. The GH response to glucose was normalised in 14 of 16 (88%) subjects. Eleven of 25 (44%) patients had a reduction in pituitary gland height. Side effects were common, but usually of a minor nature. Cholelithiasis occurred in 39% of patients. Two patients ceased octreotide because of side effects.


CONCLUSIONS
We conclude that octreotide is an effective and safe long-term treatment for acromegaly. It is a useful adjunct to surgery, and may be offered as sole therapy for patients with smaller adenomas.
Cheung
N W
NW
Department of Diabetes and Endocrinology, Westmead Hospital, NSW.
Taylor
L
L
Boyages
S C
SC
D000172:Acromegaly / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000236:Adenoma / Q000097:blood / Q000150:complications; D000328:Adult; D000368:Aged; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000097:blood / Q000150:complications; D011446:Prospective Studies; D016896:Treatment Outcome
D006728:Hormones; D007334:Insulin-Like Growth Factor I; D015282:Octreotide