Long-term Treatment of 189 Acromegalic Patients With the Somatostatin Analog Octreotide: Results of the International Multicenter Acromegaly Study Group

doi:10.1001/archinte.1991.00400080073013

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Vol. 151 No. 8, AUGUST 1991

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Long-term Treatment of 189 Acromegalic Patients With the Somatostatin Analog Octreotide

Results of the International Multicenter Acromegaly Study Group

Mary Lee Vance, MD; Alan G. Harris, MD

Arch Intern Med. 1991;151(8):1573-1578.

Abstract

Background
We wanted to determine the clinical and biochemical effectsof long-term therapy with the somatostatin analog octreotidein 189 acromegalic patients.

Methods
Patients were treated at 23 medical centers for 6 days to 231weeks (median, 24.2 weeks) with varying octreotide dosages (100to 1500µg/d; median, 300 µg/d). Serum growth hormoneand insulin-like growth factor I (IGF-I) concentrations beforeand at the end of the study were compared, and correlationsbetween the response to treatment with total daily dosage andduration of treatment were sought.

Results
The clinical response rate was 88%, irrespective of dosage ortreatment duration. Serum growth hormone levels decreased in172 (94%) of 182 patients and IGF-I levels decreased in 91 (92%)of 99. The mean pretreatment growth hormone level was 39.4 ±4.4µg/L and decreased to 12.2 ±1.5 µg/L. Growthhormone levels decreased to less than 5 µg/L in 82 (45%)of 182 patients. The pretreatment IGF-I level was 5.62±0.41U/mL and decreased to 2.64 ±0.19 U/mL; suppression to2 U/mL or lower occurred in 46 (46%) of 99 patients. The degreeof growth hormone suppression was associated with longer treatmentduration but not with the total octreotide dosage per day. In34 patients studied prospectively, pituitary tumor size decreasedby greater than 20% in 15 (44%). Side effects occurred in 37%of patients and were most commonly transient loose acholic stools,pain at the injection site, and abdominal discomfort; severitywas mild to moderate. Glucose tolerance was unchanged or improvedin 52% and declined in 48% of 25 patients evaluated.

Conclusions
Octreotide is an effective treatment for acromegaly that maybe used as primary therapy or after surgery and/or pituitaryirradiation.

(Arch Intern Med. 1991;151:1573-1578)

Author Affiliations

From the Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, Va (Dr Vance), and the Department of Neuroendocrinology and Biostatistics, Clinical Research, Sandoz Ltd, Basel, Switzerland (Dr Harris).

Footnotes

Accepted for publication January 22, 1991.

Reprint requests to Box 511, University of Virginia Health SciencesCenter, Charlottesville, VA 22908 (Dr Vance).

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