title: Lanreotide Reduces Liver Volume, But Might Not Improve Muscle Wasting or Weight Loss, in Patients With Symptomatic Polycystic Liver Disease.
abstract: OBJECTIVE
  Polycystic liver disease (PCLD) can induce malnutrition owing to extensive hepatomegaly and patients might require liver transplantation. Six months of treatment with the somatostatin analogue lanreotide (120 mg) reduces liver volume. We investigated the efficacy of a lower dose of lanreotide and its effects on nutritional status.
  
  
  METHODS
  We performed an 18-month prospective study at 2 tertiary medical centers in Belgium from January 2011 through August 2012. Fifty-nine patients with symptomatic PCLD were given lanreotide (90 mg, every 4 weeks) for 6 months. Patients with reductions in liver volume of more than 100 mL (responders, primary end point) continued to receive lanreotide (90 mg) for an additional year (18 months total). Nonresponders were offered increased doses, up to 120 mg lanreotide, until 18 months. Liver volume and body composition were measured by computed tomography at baseline and at months 6 and 18. Patients also were assessed by the PCLD-specific complaint assessment at these time points.
  
  
  RESULTS
  Fifty-three patients completed the study; 21 patients (40%) were responders. Nineteen of the responders (90%) continued as responders until 18 months. At this time point, they had a mean reduction in absolute liver volume of 430 ± 92 mL. In nonresponders (n = 32), liver volume increased by a mean volume of 120 ± 42 mL at 6 months. However, no further increase was observed after dose escalation in the 24 patients who continued to the 18-month end point. All subjects had decreased scores on all subscales of the PCLD-specific complaint assessment, including better food intake (P = .04). Subjects did not have a mean change in subcutaneous or visceral fat mass, but did have decreases in mean body weight (2 kg) and total muscle mass (1.06 cm(2)/h(2)). Subjects also had a significant mean reduction in their level of insulin-like growth factor 1, from 19% below the age-adjusted normal range level at baseline to 50% at 18 months (P = .002).
  
  
  CONCLUSIONS
  In a prospective study, we observed that low doses of lanreotide (90 mg every 4 weeks) reduced liver volumes and symptoms in patients with PCLD. However, patients continued to lose weight and muscle mass. The effects of somatostatin analogues on sarcopenia require investigation. Clinicaltrials.gov: NCT01315795.
authors.affiliation: Division and Laboratory of Hepatology, University Hospitals, KU Leuven, Leuven, Belgium. Electronic address: frederik.temmerman@uzleuven.be.
authors.forename: Frederik
authors.initials: F
authors.lastname: Temmerman
authors.affiliation: Division of Nephrology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Thien Ahn
authors.initials: TA
authors.lastname: Ho
authors.affiliation: Division of Radiology, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Ragna
authors.initials: R
authors.lastname: Vanslembrouck
authors.affiliation: Division of Radiology, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Coudyzer
authors.affiliation: Division of Laboratory Medicine, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Jaak
authors.initials: J
authors.lastname: Billen
authors.affiliation: Division of Public Health and Primary Care, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Dobbels
authors.affiliation: Division and Laboratory of Hepatology, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Jos
authors.initials: J
authors.lastname: van Pelt
authors.affiliation: Division of Nephrology, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Bammens
authors.affiliation: Division of Nephrology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Pirson
authors.affiliation: Division and Laboratory of Hepatology, University Hospitals, KU Leuven, Leuven, Belgium.
authors.forename: Frederik
authors.initials: F
authors.lastname: Nevens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D003560:Cysts / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006529:Hepatomegaly / Q000473:pathology*; D006801:Humans; D008107:Liver Diseases / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology*; D010456:Peptides, Cyclic / Q000008:administration & dosage*; D011446:Prospective Studies; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin
keywords: Clinical Trial; Growth Hormone Deficiency; Health-Related Quality of Life; POLCA; Sarcopenia; Somatostatin Analogues