Abstract
The use of somatostatin analogues for the treatment of acromegaly is now well established. Recently long-acting preparations of octreotide and lanreotide have been introduced. In this study we have assessed the efficacy and tolerability of the long acting somatostatin analogue octreotide LAR in patients with acromegaly, and compared it with lanreotide SR.
Five patients with active acromegaly were recruited; they were treated with lanreotide SR for 6 months and then, following a wash-out period, received octreotide LAR for 6 months. They were assessed at baseline, 3- and 6-months, by clinical score, GH and IGF1. Adverse effects were carefully monitored.
Both treatments effectively reduced GH and IGF1 levels. Four of five patients achieved a mean GH level of <2.5 ng/ ml with both drugs; with octreotide LAR only, these patients also had GH <1 ng/ml after oral glucose loading. The clinical symptoms score improved significantly with octreotide LAR, as did the ring size; the clinical score correlated significantly with GH. Blood glucose was not adversely affected. All patients experienced minor GI symptoms with lanreotide SR, but less frequently with octreotide LAR. Both drugs caused biliary stasis and had a tendency to form biliary sludge.
Octreotide LAR proved effective for the treatment of acromegaly and was well tolerated. Octreotide LAR had some advantages over lanreotide SR, although the differences were not great.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Melmed S, Jackson I, Kleinberg D, Klibanski A. Current treatment guidelines for acromegaly. J Clin Endocrinol & Metab. 1998;83:2646–2652.
Vance ML, Harris AG. Long-term treatment of 189 acromegalic patients with the somatostatin analogue octreotide. Results of the International Multicenter Acromegaly Study Group. Arch Intern Med 1991;151:1573–1578.
Melmed S, Ho K, Klibanski A et al. Recent advances in the pathogenesis, diagnosis and management of acromegaly. J Clin Endocrinol & Metab 1995;80:3395–3402.
Lamberts SWJ, VanderLely AJ, deHerder WW, Hofland LJ. (1996) Octreotide. N Engl J Med 1996;334:246–253.
Farooqi S, Bevan JS, Sheppard MC, Wass JAH. The therapeutic value of somatostatin and its analogues. Pituitary 1999;2:79–88.
Chiodini PG, Cozzi R, Dallabonzana D, et al. (1987) Medical treatment of acromegaly with SMS 201–995, a somatostatin analogue: a comparison with bromocriptine. J Clin Endocrinol & Metab 1987;64:477–453.
Barkan AL, Kelch RP, Hopwood NJ, Beitins IZ. Treatment of acromegaly with the long-acting somatostatin analog SMS 201–995. J Clin Endocrinol & Metab 1988;60:16–23.
McKnight JA, McCance DR, Sheridan B, et al. A long term dose-response study of somatostatin analogue (SMS 201–995 octreotide) in resistant acromegaly. Clin Endocrinol 1991;34:119–125.
Newman CB, Melmed S, Snyder PJ, et al. Safety and efficacy of long term octreotide therapy of acromegaly: results of a multicentre trial in 103 patients—A clinical research centre study. J Clin Endocrinol & Metab 1995; 80:2768–2775.
Johnson MR, Chowdrey HS, Thomas F, et al. Pharmacokinetics and efficacy of the long-acting somatostatin analogue somatuline in acromegaly. Eur J Endocrinol 1994;130:229–234.
Sassolas G. Medical therapy with somatostatin analogues for acromegaly. Eur J Endocrinol 1995;133:675–677.
Marek J, Hana V, Krsek M, et al. Long term treatment of acromegaly with the slow-release somatostatin analogue lanreotide. Eur J Endocrinol 1994;131:20–26.
Al-Maskari M, Gebbie J, Kendall-Taylor P. The effect of a new slow-release, long acting somatostatin analogue, lanreotide, in acromegaly. Clin Endocrinol 1996;45:415–421.
Caron P, Morange-Ramos I, Cogne M, Jaquet P. Three year follow-up of acromegalic patients treated with intramuscular slow-release lanreotide. J Clin Endocrinol & Metabol 1997;82:18–22.
Giusti M, Ciccarelli E, Dallabonzana D, et al. Clinical results of long-term slow release lanreotide treatment of acromegaly. Eur J Endocrinol 1997;27:277–284.
Stewart PM, Kane FK, Stewart SE, et al. Depot long-acting somatostatin analogue (Sandostatin LAR) is an effective treatment for acromegaly. J Clin Endocrinol & Metab 1995;80:3267–3272.
Lancranjan I, Bruns C, Crass P, et al. Sandostatin LAR: A Kendall-Taylor et al. promising therapeutic tool in the management of acromegalic patients. Metabolism 1996;45 Suppl 1:66–71.
Flogstad AL, Halse J, Bakke S, et al. Sandostatin LAR in acromegalic patients: long term treatment. J Clin Endocrinol & Metab 1997;82:23–28.
Morange I, de Boisvilliers F, Chanson P, et al. Slow release lanreotide treatment in acromegalic patients previously normalized by octreotide. J Clin Endocrinol & Metab 1994;79: 145–151.
Hunter SJ, Shaw JAM, Lee KO, et al. Comparison of monthly intramuscular injections of Sandostatin LAR with multiple subcutaneous injections of octreotide in the treatment of acromegaly: effects on growth hormone and other markers of growth hormone secretion. Clin Endocrinol 1999;50:245–251.
Wass JAH, Anderson JV, Besser GM, Dowling RH. Gallstones and treatment with octreotide for acromegaly. Br Med J 1989;299:1162–1163.
Verschoor L, Lamberts SWJ, Uitterlinden P, Del Pozo E. Glucose tolerance during long term treatment with a somatostatin analogue. Br Med J 1986;293:1327–1328.
James RA, Moller N, Chatterjee S, et al. Carbohydrate tolerance and serum lipids in acromegaly before and during treatment with high dose octreotide. Diab Med 1991;8:517–523.
McKnight JA, McCance DR, Crothers JG, Atkinson AB. Changes in glucose tolerance and development of gallstones during high dose treatment with octreotide for acromegaly. Br Med J 1987;299:604–605.
Turner HE, Vadivale A, Keenan J, Wass JAH. A comparison of lanreotide and octreotide for treatment of acromegaly. Clin Endocrinol 1999;51:275–284.
Newman CB, Melmed S, George A, et al. Octreotide as primary therapy for acromegaly. J Clin Endocrinol & Metab 1998;83:3034–3040.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kendall-Taylor, P., Miller, M., Gebbie, J. et al. Long-Acting Octreotide LAR Compared with Lanreotide SR in the Treatment of Acromegaly. Pituitary 3, 61–65 (2000). https://doi.org/10.1023/A:1009997506216
Issue Date:
DOI: https://doi.org/10.1023/A:1009997506216