title: Therapeutic options in the management of acromegaly: focus on lanreotide Autogel.
abstract: BACKGROUND
  In acromegaly, expert surgery is curative in only about 60% of patients. Postoperative radiation therapy is associated with a high incidence of hypopituitarism and its effect on growth hormone (GH) production is slow, so that adjuvant medical treatment becomes of importance in the management of many patients.
  
  
  OBJECTIVE
  To delineate the role of lanreotide in the treatment of acromegaly.
  
  
  METHODS
  Search of Medline, Embase, and Web of Science databases for clinical studies of lanreotide in acromegaly.
  
  
  RESULTS
  Treatment with lanreotide slow release and lanreotide Autogel((R)) normalized GH and insulin-like growth factor-I (IGF-I) concentrations in about 50% of patients. The efficacy of 120 mg lanreotide Autogel((R)) on GH and IGF-I levels was comparable with that of 20 mg octreotide LAR. There were no differences in improvement of cardiac function, decrease in pancreatic beta-cell function, or occurrence of side effects, including cholelithiasis, between octreotide LAR and lanreotide Autogel(R). When postoperative treatment with somatostatin analogs does not result in normalization of serum IGF-I and GH levels after noncurative surgery, pegvisomant alone or in combination with somatostatin analogs can control these levels in a substantial number of patients.
authors.affiliation: Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Roelfsema
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
references.citation: J Clin Endocrinol Metab. 2000 Nov;85(11):4099-103
references.pmid: 11095439
references.citation: J Neurosurg. 1996 Aug;85(2):239-47
references.pmid: 8755752
references.citation: Clin Endocrinol (Oxf). 2005 Aug;63(2):176-84
references.pmid: 16060911
references.citation: Clin Endocrinol (Oxf). 2008 Mar;68(3):458-65
references.pmid: 17941904
references.citation: J Clin Endocrinol Metab. 1999 Oct;84(10):3551-5
references.pmid: 10522994
references.citation: J Clin Endocrinol Metab. 1997 Oct;82(10):3187-91
references.pmid: 9329336
references.citation: J Clin Endocrinol Metab. 2002 Apr;87(4):1909; author reply 1909
references.pmid: 11932345
references.citation: J Clin Endocrinol Metab. 2005 Oct;90(10):5627-31
references.pmid: 16046586
references.citation: J Clin Endocrinol Metab. 2007 Dec;92(12):4598-601
references.pmid: 17895318
references.citation: J Clin Endocrinol Metab. 1994 Jul;79(1):145-51
references.pmid: 8027218
references.citation: J Clin Endocrinol Metab. 2001 Jul;86(7):2929-34
references.pmid: 11443145
references.citation: Neuro Endocrinol Lett. 2003 Oct;24(5):334-8
references.pmid: 14647007
references.citation: Clin Endocrinol (Oxf). 2006 Feb;64(2):209-14
references.pmid: 16430722
references.citation: Endocrinol Metab Clin North Am. 2008 Mar;37(1):101-22, viii
references.pmid: 18226732
references.citation: IDrugs. 2007 Dec;10(12):885-95
references.pmid: 18041687
references.citation: Pituitary. 2007;10(3):237-49
references.pmid: 17541749
references.citation: N Engl J Med. 2000 Apr 20;342(16):1171-7
references.pmid: 10770982
references.citation: Clin Endocrinol (Oxf). 2004 Aug;61(2):209-15
references.pmid: 15272916
references.citation: J Clin Endocrinol Metab. 2005 Mar;90(3):1856-63
references.pmid: 15613435
references.citation: J Endocrinol Invest. 1999 Jun;22(6):409-18
references.pmid: 10435849
references.citation: Treat Endocrinol. 2005;4(1):43-53
references.pmid: 15649100
references.citation: J Neurochem. 2004 Jun;89(5):1057-91
references.pmid: 15147500
references.citation: Clin Endocrinol (Oxf). 2003 Jul;59(1):115-28
references.pmid: 12807513
references.citation: J Clin Endocrinol Metab. 2005 Aug;90(8):4465-73
references.pmid: 15886238
references.citation: Clin Endocrinol (Oxf). 2000 May;52(5):549-55
references.pmid: 10792333
references.citation: J Clin Endocrinol Metab. 2005 Jul;90(7):4081-6
references.pmid: 15886256
references.citation: Pituitary. 2007;10(1):19-25
references.pmid: 17273921
references.citation: Endocrinol Metab Clin North Am. 1992 Sep;21(3):713-35
references.pmid: 1355728
references.citation: Clin Endocrinol (Oxf). 1996 Oct;45(4):415-21
references.pmid: 8959079
references.citation: Eur J Endocrinol. 2007 Nov;157(5):579-87
references.pmid: 17984237
references.citation: Clin Endocrinol (Oxf). 2003 Oct;59(4):492-9
references.pmid: 14510913
references.citation: Clin Endocrinol (Oxf). 1999 May;50(5):561-7
references.pmid: 10468920
references.citation: Neuroendocrinology. 2006;83(3-4):230-9
references.pmid: 17047388
references.citation: Q J Med. 1970 Jan;39(153):1-16
references.pmid: 5427331
references.citation: Proc Natl Acad Sci U S A. 2003 Sep 2;100(18):10258-62
references.pmid: 12930900
references.citation: Clin Endocrinol (Oxf). 2008 Aug;69(2):299-305
references.pmid: 18248639
references.citation: Eur J Endocrinol. 2005 Aug;153(2):239-48
references.pmid: 16061830
references.citation: Eur J Endocrinol. 1994 Jun;130(6):581-6
references.pmid: 8205258
references.citation: J Clin Endocrinol Metab. 1989 Dec;69(6):1225-33
references.pmid: 2511221
references.citation: BMJ. 1992 May 23;304(6838):1343-6
references.pmid: 1611331
references.citation: Biophys J. 2008 Mar 1;94(5):1782-95
references.pmid: 17993497
references.citation: J Clin Endocrinol Metab. 2003 Aug;88(8):3567-72
references.pmid: 12915637
references.citation: Endocr Rev. 2004 Feb;25(1):102-52
references.pmid: 14769829
references.citation: J Clin Endocrinol Metab. 2003 Nov;88(11):5258-65
references.pmid: 14602759
references.citation: Eur J Endocrinol. 1999 Sep;141(3):267-71
references.pmid: 10474124
references.citation: Clin Endocrinol (Oxf). 2008 Mar;68(3):343-9
references.pmid: 17892497
references.citation: J Clin Endocrinol Metab. 2001 Jul;86(7):2935-41
references.pmid: 11443146
references.citation: Br J Clin Pharmacol. 1994 Sep;38(3):213-9
references.pmid: 7826822
references.citation: J Clin Endocrinol Metab. 2006 Jun;91(6):2112-8
references.pmid: 16537687
references.citation: J Clin Endocrinol Metab. 1998 Feb;83(2):374-8
references.pmid: 9467544
references.citation: J Clin Invest. 2004 Aug;114(3):349-56
references.pmid: 15286801
references.citation: Clin Endocrinol (Oxf). 2005 Jun;62(6):742-7
references.pmid: 15943838
references.citation: Eur J Endocrinol. 2004 Apr;150(4):489-95
references.pmid: 15080778
references.citation: Clin Endocrinol (Oxf). 1999 Aug;51(2):159-64
references.pmid: 10468985
references.citation: Eur J Endocrinol. 1998 Feb;138(2):160-3
references.pmid: 9506859
references.citation: N Engl J Med. 2007 Jan 4;356(1):29-38
references.pmid: 17202453
references.citation: Eur J Endocrinol. 2007 Jan;156(1):75-82
references.pmid: 17218728
references.citation: Eur J Endocrinol. 2004 Apr;150(4):465-71
references.pmid: 15080775
references.citation: Lancet. 2001 Nov 24;358(9295):1754-9
references.pmid: 11734231
references.citation: J Clin Endocrinol Metab. 1997 Jan;82(1):18-22
references.pmid: 8989225
references.citation: J Clin Endocrinol Metab. 2001 Jul;86(7):2976-81
references.pmid: 11443154
references.citation: J Clin Endocrinol Metab. 2001 Apr;86(4):1645-52
references.pmid: 11297598
references.citation: Metabolism. 2002 Mar;51(3):387-93
references.pmid: 11887179
references.citation: J Clin Endocrinol Metab. 2004 Feb;89(2):667-74
references.pmid: 14764779
references.citation: J Clin Endocrinol Metab. 2004 Apr;89(4):1613-7
references.pmid: 15070920
references.citation: Horm Res. 2007;68 Suppl 5:166-72
references.pmid: 18174739
references.citation: J Clin Endocrinol Metab. 2000 May;85(5):2068-71
references.pmid: 10843197
references.citation: Pituitary. 2000 May;2(4):269-76
references.pmid: 11081148
references.citation: Front Neuroendocrinol. 1999 Jul;20(3):157-98
references.pmid: 10433861
references.citation: Acta Med Scand. 1988;223(4):327-35
references.pmid: 3369313
references.citation: Clin Endocrinol (Oxf). 2006 Sep;65(3):320-6
references.pmid: 16918950
references.citation: Trends Endocrinol Metab. 2000 May-Jun;11(4):132-7
references.pmid: 10754534
references.citation: Clin Endocrinol (Oxf). 2005 Nov;63(5):514-9
references.pmid: 16268802
references.citation: Am J Cardiol. 1999 May 15;83(10):1506-9, A8
references.pmid: 10335774
references.citation: Int J Nanomedicine. 2006;1(4):385-98
references.pmid: 17722273
references.citation: Am J Physiol. 1986 Mar;250(3 Pt 1):E269-73
references.pmid: 3513613
references.citation: J Clin Endocrinol Metab. 2005 May;90(5):2731-9
references.pmid: 15741257
references.citation: J Clin Endocrinol Metab. 2000 Dec;85(12):4596-602
references.pmid: 11134114
references.citation: Endocr Rev. 2001 Feb;22(1):53-74
references.pmid: 11159816
references.citation: J Clin Endocrinol Metab. 1995 May;80(5):1577-83
references.pmid: 7745003
references.citation: J Clin Pharmacol. 2005 Jul;45(7):836-44
references.pmid: 15951474
references.citation: Medicine (Baltimore). 1994 Sep;73(5):233-40
references.pmid: 7934807
references.citation: J Clin Endocrinol Metab. 2004 Jan;89(1):71-5
references.pmid: 14715829
references.citation: Acta Neurochir (Wien). 1999;141(4):399-405
references.pmid: 10352750
references.citation: J Clin Endocrinol Metab. 1967 Oct;27(10):1418-30
references.pmid: 6057823
references.citation: Pituitary. 2007;10(2):115-9
references.pmid: 17429592
references.citation: J Clin Endocrinol Metab. 2003 Jul;88(7):3105-12
references.pmid: 12843150
references.citation: J Clin Endocrinol Metab. 1991 May;72(5):1048-53
references.pmid: 2022706
references.citation: J Clin Endocrinol Metab. 1997 Oct;82(10):3308-14
references.pmid: 9329359
references.citation: Growth Horm IGF Res. 2005 Jun;15(3):200-6
references.pmid: 15935982
references.citation: J Clin Endocrinol Metab. 2005 Aug;90(8):4483-8
references.pmid: 15899958
references.citation: Eur J Endocrinol. 2005 Jul;153(1):67-71
references.pmid: 15994747
references.citation: Exp Clin Endocrinol Diabetes. 2005 Mar;113(3):139-44
references.pmid: 15789272
references.citation: Clin Endocrinol (Oxf). 1980 Jan;12(1):53-9
references.pmid: 7379314
references.citation: Eur J Endocrinol. 1994 Mar;130(3):229-34
references.pmid: 7908838
references.citation: Rev Endocr Metab Disord. 2008 Mar;9(1):41-58
references.pmid: 18157698
references.citation: J Clin Endocrinol Metab. 2005 Jun;90(6):3337-41
references.pmid: 15755865
references.citation: Eur J Endocrinol. 1994 Jul;131(1):20-6
references.pmid: 7913650
references.citation: J Neurosurg. 1998 Sep;89(3):353-8
references.pmid: 9724106
references.citation: Clin Endocrinol (Oxf). 2007 Oct;67(4):512-9
references.pmid: 17555511
references.citation: Clin Endocrinol (Oxf). 2004 Jun;60(6):734-40
references.pmid: 15163338
references.citation: J Neurosurg. 1998 Jun;88(6):1002-8
references.pmid: 9609294
references.citation: Eur J Endocrinol. 2000 Nov;143(5):577-84
references.pmid: 11078980
references.citation: J Neurosurg. 2005 Apr;102(4):678-91
references.pmid: 15871511
references.citation: Clin Endocrinol (Oxf). 2008 Mar;68(3):473-80
references.pmid: 17941902
references.citation: J Endocrinol Invest. 2003 Jun;26(6):533-8
references.pmid: 12952367
references.citation: Metabolism. 1992 Sep;41(9 Suppl 2):22-33
references.pmid: 1355588
references.citation: Eur J Endocrinol. 2008 Mar;158(3):295-303
references.pmid: 18299461
references.citation: Eur J Endocrinol. 2004 Apr;150(4):473-80
references.pmid: 15080776
references.citation: Psychother Psychosom. 1999;68(3):165-7
references.pmid: 10224516
references.citation: Clin Endocrinol (Oxf). 2000 Nov;53(5):577-86
references.pmid: 11106918
references.citation: Zentralbl Neurochir. 2005 Aug;66(3):126-32; discussion 132
references.pmid: 16116555
references.citation: J Clin Endocrinol Metab. 1999 Feb;84(2):527-32
references.pmid: 10022411
references.citation: Expert Rev Endocrinol Metab. 2006 May;1(3):449-460
references.pmid: 30764082
references.citation: Pituitary. 2000 Oct;3(2):61-5
references.pmid: 11141697
references.citation: J Clin Endocrinol Metab. 1988 Nov;67(5):1040-8
references.pmid: 2903168
references.citation: Pituitary. 2007;10(2):121-8
references.pmid: 17429590
references.citation: J Endocrinol Invest. 1993 Sep;16(8):565-72
references.pmid: 8258643
references.citation: Eur J Endocrinol. 1998 Feb;138(2):164-9
references.pmid: 9506860
references.citation: Science. 1973 Jan 5;179(4068):77-9
references.pmid: 4682131
references.citation: J Clin Endocrinol Metab. 2005 Jul;90(7):4405-10
references.pmid: 15827109
references.citation: Horm Metab Res. 2000 Jun;32(6):224-9
references.pmid: 10898551
references.citation: J Clin Endocrinol Metab. 1993 Mar;76(3):721-7
references.pmid: 8095269
references.citation: Endocr Rev. 2003 Feb;24(1):28-47
references.pmid: 12588807
references.citation: J Clin Endocrinol Metab. 2002 Sep;87(9):4054-8
references.pmid: 12213843
references.citation: Eur J Clin Invest. 1997 Apr;27(4):277-84
references.pmid: 9134375
references.citation: Clin Endocrinol (Oxf). 1980 Jan;12(1):71-9
references.pmid: 7379316
references.citation: Q J Med. 1993 May;86(5):293-9
references.pmid: 8327647
references.citation: Eur J Endocrinol. 2001 Aug;145(2):137-45
references.pmid: 11454508
references.citation: Clin Endocrinol (Oxf). 2005 Mar;62(3):282-8
references.pmid: 15730408
references.citation: Ulster Med J. 1990 Apr;59(1):55-62
references.pmid: 2349750
references.citation: J Endocrinol Invest. 1999 Jan;22(1):40-7
references.pmid: 10090136
references.citation: J Pharm Pharmacol. 2004 Apr;56(4):471-6
references.pmid: 15099442
references.citation: J Clin Endocrinol Metab. 1998 Oct;83(10):3419-26
references.pmid: 9768641
references.citation: J Clin Endocrinol Metab. 2003 Jul;88(7):3090-8
references.pmid: 12843148
references.citation: N Engl J Med. 1996 Jan 25;334(4):246-54
references.pmid: 8532003
references.citation: Eur J Endocrinol. 2006 Dec;155(6):831-7
references.pmid: 17132752
references.citation: J Clin Endocrinol Metab. 1994 Dec;79(6):1706-15
references.pmid: 7989479
references.citation: Clin Endocrinol (Oxf). 1999 Sep;51(3):275-80
references.pmid: 10469005
references.citation: Clin Endocrinol (Oxf). 2008 Jun;68(6):970-5
references.pmid: 18031313
references.citation: Eur J Endocrinol. 2007 Apr;156 Suppl 1:S29-S35
references.pmid: 17413185
references.citation: Endocr Rev. 2003 Jun;24(3):272-7
references.pmid: 12788799
references.citation: Eur J Endocrinol. 2008 Mar;158(3):305-10
references.pmid: 18299462
references.citation: J Clin Endocrinol Metab. 2004 Jun;89(6):2789-96
references.pmid: 15181059
references.citation: J Clin Endocrinol Metab. 2007 May;92(5):1743-7
references.pmid: 17311857
references.citation: Pituitary. 2000 Dec;3(4):231-8
references.pmid: 11788011
references.citation: Am J Physiol Endocrinol Metab. 2004 Jan;286(1):E25-30
references.pmid: 14506078
references.citation: Eur J Endocrinol. 2005 Aug;153(2):231-8
references.pmid: 16061829
references.citation: Clin Endocrinol (Oxf). 2003 Apr;58(4):471-81
references.pmid: 12641631
references.citation: Eur J Endocrinol. 2001 Dec;145(6):717-26
references.pmid: 11720896
references.citation: J Clin Endocrinol Metab. 2002 Jan;87(1):99-104
references.pmid: 11788630
references.citation: J Clin Endocrinol Metab. 1996 Jun;81(6):2356-62
references.pmid: 8964877
references.citation: Clin Endocrinol (Oxf). 2000 Sep;53(3):321-7
references.pmid: 10971449
references.citation: Clin Endocrinol (Oxf). 2005 Feb;62(2):210-6
references.pmid: 15670198
references.citation: Clin Endocrinol (Oxf). 2001 Aug;55(2):183-9
references.pmid: 11531924
references.citation: Clin Endocrinol (Oxf). 2003 Jan;58(1):86-91
references.pmid: 12519417
references.citation: Pituitary. 2001 Sep;4(4):223-30
references.pmid: 12501972
references.citation: J Clin Endocrinol Metab. 2006 Jan;91(1):85-92
references.pmid: 16263832
references.citation: Neurosurgery. 2001 Jun;48(6):1239-43; discussion 1244-5
references.pmid: 11383725
references.citation: Eur J Clin Invest. 1992 Dec;22(12):793-9
references.pmid: 1478250
references.citation: Eur J Endocrinol. 2008 Jan;158(1):19-25
references.pmid: 18166813
references.citation: Clin Endocrinol (Oxf). 1994 Jul;41(1):75-83
references.pmid: 8050134
references.citation: Eur J Endocrinol. 2005 Mar;152(3):379-87
references.pmid: 15757854
references.citation: Clin Endocrinol (Oxf). 2008 Jan;68(1):136-42
references.pmid: 17803712
references.citation: Pituitary. 2004;7(4):257-64
references.pmid: 16132202
references.citation: Eur J Endocrinol. 2007 Nov;157(5):571-7
references.pmid: 17984236
references.citation: Eur J Endocrinol. 2007 Apr;156 Suppl 1:S23-S28
references.pmid: 17413184
references.citation: Proc Natl Acad Sci U S A. 1999 Jun 8;96(12):7088-92
references.pmid: 10359843
references.citation: Clin Endocrinol (Oxf). 2003 Feb;58(2):128-31
references.pmid: 12580924
references.citation: Lancet. 2005 May 7-13;365(9471):1644-6
references.pmid: 15885297
references.citation: J Clin Endocrinol Metab. 1998 Aug;83(8):2730-4
references.pmid: 9709939
references.citation: Metabolism. 1996 Aug;45(8 Suppl 1):72-4
references.pmid: 8769388
references.citation: Eur J Endocrinol. 2004 Sep;151(3):317-24
references.pmid: 15362960
references.citation: Eur J Endocrinol. 2006 Jul;155(1):73-8
references.pmid: 16793952
references.citation: Growth Horm IGF Res. 2003 Aug;13 Suppl A:S144-51
references.pmid: 12914744
references.citation: J Clin Endocrinol Metab. 2000 Oct;85(10):3779-85
references.pmid: 11061538
references.citation: J Clin Endocrinol Metab. 2004 Nov;89(11):5369-76
references.pmid: 15531483
references.citation: Clin Endocrinol (Oxf). 2004 Nov;61(5):531-43
references.pmid: 15521954
references.citation: Eur J Endocrinol. 2004 Dec;151(6):643-55
references.pmid: 15588232
references.citation: Endocrinology. 1992 Apr;130(4):1816-21
references.pmid: 1547711
references.citation: Clin Endocrinol (Oxf). 2002 Jan;56(1):65-71
references.pmid: 11849248
references.citation: N Engl J Med. 2006 Dec 14;355(24):2558-73
references.pmid: 17167139
references.citation: J Clin Endocrinol Metab. 2000 Feb;85(2):526-9
references.pmid: 10690849
references.citation: Lancet. 1964 Oct 10;2(7363):769-71
references.pmid: 14187461
references.citation: N Engl J Med. 1983 Dec 15;309(24):1495-501
references.pmid: 6139753
references.citation: Eur J Endocrinol. 2004 Oct;151(4):439-46
references.pmid: 15476442
references.citation: J Clin Endocrinol Metab. 2008 Jan;93(1):61-7
references.pmid: 17971431
references.citation: J Clin Endocrinol Metab. 2001 Sep;86(9):4072-7
references.pmid: 11549628
references.citation: J Clin Endocrinol Metab. 1995 Sep;80(9):2768-75
references.pmid: 7673422
references.citation: Eur J Endocrinol. 2006 Feb;154(2):267-74
references.pmid: 16452540