title: Monotherapy with lanreotide depot for acromegaly: long-term clinical experience in a pituitary center.
abstract: OBJECTIVE
  Long-acting somatostatin analogs are one of the main classes of medical therapy used for acromegaly and most patients require ongoing treatment. Few studies have evaluated the long-term efficacy and safety of lanreotide depot beyond 2 years. The goal of this study was to provide a long-term longitudinal assessment of efficacy and safety of lanreotide depot in lanreotide responders compared to a surgically cured control group.
  
  
  METHODS
  In this retrospective longitudinal case-control study, patients with acromegaly receiving lanreotide depot monotherapy continuously for at least 24 months (N = 24) and surgically cured patients (N = 39) were compared. Serum IGF-1, pituitary MRIs, lanreotide dose, co-morbidities and adverse effects were assessed longitudinally.
  
  
  RESULTS
  In the lanreotide group, IGF-1 remained normal and unchanged over 6 years; comparable to the surgery only group. There was no difference in prevalence of normal IGF-1 between the lanreotide and surgery only groups at 6 months (100 vs. 97 %), 6 years (89 vs. 90 %) and at last follow-up (96 vs. 92 %). Tumor size remained stable (79 %) or decreased (21 %) in the lanreotide group. In the surgery only group, tumor size remained unchanged in all patients. Hemoglobin A1C did not differ between lanreotide and surgery only groups (baseline 5.8 vs. 6.1 %; last follow-up 6.0 vs. 5.7 %). Two (8 %) of the lanreotide and none of the surgery only group developed new diabetes mellitus.
  
  
  CONCLUSIONS
  Lanreotide depot maintains normalization of IGF-1 in 89 % of responders after 6 years, comparable to surgically cured controls, and controlled tumor size in all without significant adverse effects.
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA.
authors.forename: Babak Torabi
authors.initials: BT
authors.lastname: Sagvand
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA.
authors.forename: Shafaq
authors.initials: S
authors.lastname: Khairi
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Haghshenas
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
authors.forename: Brooke
authors.initials: B
authors.lastname: Swearingen
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Tritos
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Miller
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
authors.affiliation: Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA. lnachtigall@mgh.harvard.edu.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Nachtigall
mesh_terms: D000236:Adenoma / Q000188:drug therapy* / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D003692:Delayed-Action Preparations; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D012189:Retrospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D003692:Delayed-Action Preparations; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I
keywords: Acromegaly; IGF-1; Lanreotide depot; Somatostatin analogs; Somatostatin receptor ligands