title: The value of an acute octreotide suppression test in predicting short-term efficacy of somatostatin analogues in acromegaly.
abstract: Predicting the efficacy of long-acting somatostatin analogues (SSA) remains a challenge. We aim to quantitatively evaluate the predictive value of the octreotide suppression test (OST) in short-term efficacy of SSA in active acromegaly. Sixty-seven newly diagnosed acromegaly patients were assessed with OST. Subsequently, all patients were treated with long-acting SSA for 3 months, followed by reassessment. Nine parameters were tested, including GHn(the nadir GH during OST), ΔGH1 (= [GH0h-GHn]/GH0h, GH0hwas the baseline GH during OST), ΔGH2 (= [GHm-GHn]/GHm, GHmwas the mean GH on day curve), AUC(0-6h)(the GH area under the curve during OST) , ΔAUC1 (= [GH0h-AUC(0-6h)]/GH0h), ΔAUC2 (=[GHm-AUC(0-6h)]/GHm), AUC(m-6h)(the GH AUC during OST where GHmwas used instead of GH0h), ΔAUC1' (=[GH0h-AUC(m-6h)]/GH0h) and ΔAUC2' (=[GHm-AUC(m-6h)]/GHm). The Youden indices were calculated to determine the optimal cutoffs to predict the short-term efficacy of SSA. ΔGH2 more than 86.83%, ΔAUC2 more than -57.48% and ΔAUC2' more than -57.98% provided the best predictors of a good GH response (sensitivity 93.8%, specificity 85.7%). ΔGH2 more than 90.51% provided the best predictor of a good tumor size response (sensitivity 84.8%, specificity 87.5%). The percentage fall of GHn(ΔGH) was a better predictive parameter than GHn. OST showed higher efficiency in predicting the efficacy of octreotide LAR than lanreotide SR. In conclusion, OST is a valid tool to predict both GH and tumor size response to short-term efficacy of SSA in acromegaly, especially for octreotide LAR. GHmis better to be used as basal GH than GH0during OST.
authors.affiliation: Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Shen
authors.forename: Wenqiang
authors.initials: W
authors.lastname: He
authors.forename: Yeping
authors.initials: Y
authors.lastname: Yang
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Liu
authors.forename: Yun
authors.initials: Y
authors.lastname: Lu
authors.forename: Zengyi
authors.initials: Z
authors.lastname: Ma
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ye
authors.forename: Yichao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Zhao
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.forename: Ji
authors.initials: J
authors.lastname: Hu
authors.forename: Yun
authors.initials: Y
authors.lastname: Huang
authors.forename: Xuefei
authors.initials: X
authors.lastname: Shou
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Wang
authors.forename: Hongying
authors.initials: H
authors.lastname: Ye
authors.forename: Yiming
authors.initials: Y
authors.lastname: Li
authors.forename: Shiqi
authors.initials: S
authors.lastname: Li
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhao
authors.forename: Zhaoyun
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000172:Acromegaly / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003940:Diagnostic Techniques, Endocrine; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000494:pharmacology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013004:Somatostatin; D015282:Octreotide