[Usefulness of GH and IGF-1 to establish the dose and frequency of application of octreotide to treat acromegaly].
OBJECTIVE
to determine the dose and frequency of application of octreotide LAR to treat acromegaly by monitoring the levels of circulating growth hormone (GH) and insulin-like growth factor (IGF-1).


METHODS
twelve patients (five men and seven women) with acromegaly, whose age was on average 48.9 years (range 35-67) participated. Eight had been surgically treated, yet non cured and 4 patients were treated de novo. The study lasted between 12-18 months. The initial octreotide dose was 20 mg/4 weeks intramuscular. Before administering the fourth dose, the levels of IGF-1 and GH were measured; then, the dose was adjusted and three more injections were applied. If the levels of GH and IGF-1 continued safe, the dose and frequency of application of octreotide LAR were individualized thus applying the minimum number of injections.


RESULTS
the interval of octreotide LAR application to maintain the levels of GH and IGF-1 within safe range was prolonged to more than four weeks in nine patients (75%); in six patients (50%), the interval changed to eight weeks and to twelve weeks in three patients (25%). Three patients (25%) continued receiving injections in four-week intervals. The levels of GH and IGF-1 were lower during the treatment period when compared with the baseline measurements (p < 0.01).


CONCLUSIONS
the adjustment of the dose of octreotide LAR keeps the levels of GH within safe range and reduces in 75% the frequency of injections to treat acromegaly.
Martínez-Delgado
Ignacio Alejandro
IA
Dirección de Educación e Investigación en Salud, Unidad Médica de Alta Especialidad, Hospital de Cardiología 34, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, Mexico. ignacio.martinez@imss.gob.mx
Gómez-Martínez
Graciela
G
D000172:Acromegaly / Q000097:blood* / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage*
D015415:Biomarkers; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide