title: Effects of high-dose octreotide LAR on glucose metabolism in patients with acromegaly inadequately controlled by conventional somatostatin analog therapy.
abstract: OBJECTIVE
  In this study, the effect of high-dose octreotide LAR on glucose metabolism in patients with acromegaly was investigated.
  
  
  METHODS
  A post-hoc analysis of a clinical trial enrolling 26 patients with acromegaly not controlled by standard maximal somatostatin analog (SSAs) dose and randomized to receive high-dose (60  mg/28 days) or high-frequency (30  mg/21 days) octreotide i.m. injection (octreotide LAR) for 6 months.
  
  
  METHODS
  Glucose metabolic status was defined as worsened when a progression from normoglycemia to impaired fasting glucose (IFG) or from IFG to diabetes occurred or when an increase of HbAlc by at least 0.5% was demonstrated. An improvement of glucose metabolism was defined in the presence of a regression from IFG to normoglycemia and/or when HbAlc decreased by at least 0.5%.
  
  
  RESULTS
  Glucose metabolic status remained unchanged in a majority of patients (16/26 patients, 65.3%), worsened in six patients, and improved in four patients. Pre-existing metabolic status did not predict worsening of glucose metabolism, which, conversely, was significantly related to persistent biochemical activity of the disease. In fact, patients with worsened glucose metabolism exhibited a less frequent decrease in serum GH and IGF1 levels, compared with patients with improved or unchanged glucose metabolism (2/6 vs 18/20; P=0.01).
  
  
  CONCLUSIONS
  An increase in octreotide LAR dose or frequency did not impact on glucose metabolism in most patients. Worsening of glucose metabolic status occurred in close relation with persistently uncontrolled acromegaly.
authors.affiliation: Department of Medical and Surgical Sciences, University of Brescia, 25125 Brescia, Italy.
authors.forename: Gherardo
authors.initials: G
authors.lastname: Mazziotti
authors.forename: Teresa
authors.initials: T
authors.lastname: Porcelli
authors.forename: Fausto
authors.initials: F
authors.lastname: Bogazzi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Bugari
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cannavò
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Renato
authors.initials: R
authors.lastname: Cozzi
authors.forename: Laura
authors.initials: L
authors.lastname: De Marinis
authors.forename: Ettore
authors.initials: E
authors.lastname: degli Uberti
authors.forename: Silvia
authors.initials: S
authors.lastname: Grottoli
authors.forename: Francesco
authors.initials: F
authors.lastname: Minuto
authors.forename: Marcella
authors.initials: M
authors.lastname: Montini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Spinello
authors.forename: Andrea
authors.initials: A
authors.lastname: Giustina
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D005947:Glucose; D006442:Glycated Hemoglobin; D015282:Octreotide; D013004:Somatostatin