Treatment of Chinese acromegaly with a combination of bromocriptine and octreotide.
BACKGROUND
Good results have been reported with combined use of octreotide and bromocriptine in acromegalic Caucasians. Data concerning the efficacy and tolerability of this combination treatment in Chinese acromegalic patients are scanty.


OBJECTIVE
The aim of this study was to assess the efficacy and tolerability of combined therapy using bromocriptine and octreotide in the treatment of acromegaly in Chinese patients and to compare the cost-effectiveness of various regimes.


METHODS
Sixteen Chinese acromegalic patients with growth hormone (GH) concentration not suppressible to below 5 mU/L (2 microg/L) during an extended OGTT were recruited to undergo four phases of the study. During the study period, the patients were given bromocriptine alone, bromocriptine and low dose octreotide, bromocriptine and medium dose octreotide, and medium dose octreotide alone. Plasma concentrations of GH and insulin-like growth factor-1 (IGF-1) were measured before and after the completion of each phase.


RESULTS
The number of patients reaching target GH concentrations was significantly higher when treated with octreotide compared to baseline (p<0.05). Bromocriptine alone had a significant effect but not to the extent of octreotide alone. A combination of low dose octreotide and bromocriptine is as efficacious in the treatment of acromegaly as high dose octreotide. None of the patients suffered from serious adverse effects.


CONCLUSIONS
The results confirmed the usefulness and tolerability of bromocriptine and octreotide in Chinese acromegalics. The most cost-effective regime in this study was a combination of low dose octreotide and bromocriptine.
Li
J K
JK
Department of Medicine, Yan Chai Hospital, New Territories, Hong Kong. junekyli@hotmail.com
Chow
C C
CC
Yeung
V T
VT
Mak
T W
TW
Ko
G T
GT
Swaminathan
R
R
Chan
J C
JC
Cockram
C S
CS
D000172:Acromegaly / Q000097:blood / Q000188:drug therapy* / Q000191:economics; D000328:Adult; D000368:Aged; D001971:Bromocriptine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006723:Hong Kong; D006727:Hormone Antagonists / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006728:Hormones / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D006727:Hormone Antagonists; D006728:Hormones; D001971:Bromocriptine; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide