title: Patient-reported outcomes of parenteral somatostatin analogue injections in 195 patients with acromegaly.
abstract: BACKGROUND
  Long-acting somatostatin analogues delivered parenterally are the most widely used medical treatment in acromegaly. This patient-reported outcomes survey was designed to assess the impact of chronic injections on subjects with acromegaly.
  
  
  METHODS
  The survey was conducted in nine pituitary centres in Germany, UK and The Netherlands. The questionnaire was developed by endocrinologists and covered aspects of acromegaly symptoms, injection-related manifestations, emotional and daily life impact, treatment satisfaction and unmet medical needs.
  
  
  RESULTS
  In total, 195 patients participated, of which 112 (57%) were on octreotide (Sandostatin LAR) and 83 (43%) on lanreotide (Somatuline Depot). The majority (>70%) of patients reported acromegaly symptoms despite treatment. A total of 52% of patients reported that their symptoms worsen towards the end of the dosing interval. Administration site pain lasting up to a week following injection was the most frequently reported injection-related symptom (70% of patients). Other injection site reactions included nodules (38%), swelling (28%), bruising (16%), scar tissue (8%) and inflammation (7%). Injection burden was similar between octreotide and lanreotide. Only a minority of patients received injections at home (17%) and 5% were self-injecting. Over a third of patients indicated a feeling of loss of independence due to the injections, and 16% reported repeated work loss days. Despite the physical, emotional and daily life impact of injections, patients were satisfied with their treatment, yet reported that modifications that would offer major improvement over current care would be 'avoiding injections' and 'better symptom control'.
  
  
  CONCLUSIONS
  Lifelong injections of long-acting somatostatin analogues have significant burden on the functioning, well-being and daily lives of patients with acromegaly.
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands christian.strasburger@charite.de.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Strasburger
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Niki
authors.initials: N
authors.lastname: Karavitaki
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Sylvère
authors.initials: S
authors.lastname: Störmann
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Trainer
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Ilonka
authors.initials: I
authors.lastname: Kreitschmann-Andermahr
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Michael
authors.initials: M
authors.lastname: Droste
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Márta
authors.initials: M
authors.lastname: Korbonits
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Berit
authors.initials: B
authors.lastname: Feldmann
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Zopf
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Violet Fazal
authors.initials: VF
authors.lastname: Sanderson
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Schwicker
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Dana
authors.initials: D
authors.lastname: Gelbaum
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Asi
authors.initials: A
authors.lastname: Haviv
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.affiliation: Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000236:Adenoma / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D017281:Cost of Illness; D003692:Delayed-Action Preparations; D005260:Female; D005858:Germany; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000188:drug therapy*; D006801:Humans; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015282:Octreotide / Q000627:therapeutic use*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D057566:Self Report; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003692:Delayed-Action Preparations; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D015282:Octreotide