EFFICIENCY OF THE ACROMEGALIC PATIENTS’ TREATMENT WITH DIFFERENT DOSES OF SANDOSTATIN LAR IN MOSCOW REGION

Cover Page


Cite item

Full Text

Abstract

Background: Somatostatin analogues therapy is an important part of the acromegalic patients’ treatment. Aim: Assessment of treatment efficiency for patients with acromegaly using different doses of somatostatin analogues. Materials and methods: The data of 128 acromegaly patients registered in Moscow Region were analyzed, 79 (61.7%) of them were treated with somatostatin analogues. The treatment was started with a dose of 20 mg. If the target levels of growth hormone (GH) and type 1 insulin-like growth factor (IGF-1) were not achieved within 6-12 months, the dose was increased to 30 mg, and then to 40 mg. If GH and IGF-1 levels fell under the target values, the dose was decreased to 10 mg. The rate of achievement of optimal GH and IGF-1 levels was analyzed depending on the somatostatin analogue doses used. Results: The percentage of the acromegalic patients who were under the first and the second lines of drug therapy, was almost similar:  55.7 and 44.3%, respectively. Sandostatin LAR in dose of 10 mg was given to 4 (5.1%) of 79 patients, 20 mg – to 33 (41.8%), 30 mg – to 11 (13.9%), and 40 mg – to 31 (39.2%) patients. The target levels of GH and IGF-1 were achieved in 57.6, 54.5, and 32.2% of patients, who received preparation in doses 20, 30, and 40 mg, respectively. Achievement of, at least, one planned criterium (GH or IGF-1) was additionally noted in 10 of 33 (30.3%), 4 of 11 (36.2%), and 9 of 31 (29%) patients within these study groups. The rate of side effects didn’t increase with the raising of оctreotide dose. Conclusion: Application of long-acting release octreotide (Sandostatin-LAR) in doses of 30 and 40 mg is safe and allows to increase percentage of acromegalic patients who achieve a biochemical control over acromegaly.

About the authors

A. V. Dreval’

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: fake@neicon.ru

MD, PhD, Professor, Head of the Department of Therapeutic Endocrinology, MONIKI; Chief endocrinologist of Moscow Region

Russian Federation

Yu. G. Pokramovich

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Author for correspondence.
Email: pokramovich_81@mail.ru
physician of the Department of Therapeutic Endocrinology, MONIKI Russian Federation

I. V. Trigolosova

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: fake@neicon.ru
PhD, senior scientific worker, Department of Therapeutic Endocrinology, MONIKI Russian Federation

A. V. Vinogradova

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: fake@neicon.ru

physician of the Department of Therapeutic Endocrinology, MONIKI

Russian Federation

I. A. Ilovayskaya

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: fake@neicon.ru

PhD, senior scientific worker, Department of Therapeutic Endocrinology, MONIKI

Russian Federation

References

  1. Melmed S. Medical progress: acromegaly. N Engl J Med. 2006;355(24):2558-73.
  2. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25(1):102-52.
  3. Древаль АВ, Иловайская ИА, Триголосова ИВ, Покрамович ЮГ. Алгоритмы диагностики и лечения акромегалии: методическое пособие для врачей. М.: Перо; 2013. (Dreval’ AV, Ilovayskaya IA, Trigolosova IV, Pokramovich YuG. [Algorithms of diagnostics and treatment of acromegaly: A Hand-book for Physicians]. Moscow: Pero; 2013. Russian).
  4. Мельниченко ГА, Пронин ВС. Современные схемы фармакотерапии акромегалии. Врач. 2008;(8):9-13. (Mel’nichenko GA, Pronin VS. [Contemporary schemes for acromegaly therapy]. Vrach. 2008;(8):9-13. Russian).
  5. Молитвословова НН. Акромегалия: современные достижения в диагностике и лечении. Проблемы эндокринологии. 2011;(1):46-59. (Molitvoslovova NN. [Acromegaly: contemporary achievements in diagnostics and treatment]. Problemy endokrinologii. 2011;(1):46-59. Russian).
  6. Melmed S, Colao A, Barkan A, Molitch M, Grossman AB, Kleinberg D, Clemmons D, Chanson P, Laws E, Schlechte J, Vance ML, Ho K, Giustina A; Acromegaly Consensus Group. Guidelines for acromegaly management: an update. J Clin Endocrinol Metab. 2009;94(5):1509-17.
  7. Древаль АВ, Камынина ТС, Нечаева ОА, Покрамович ЮГ. Московский областной регистр больных акромегалией. Проблемы эндокринологии. 2008;(4):27-31. (Dreval’ AV, Kamynina TS, Nechaeva OA, Pokramovich YuG. [Moscow Regional Register of the acromegaly patients]. Problemy endokrinologii. 2008;(4):27-31. Russian).
  8. Ayuk J, Sheppard MC. Does acromegaly enhance mortality? Rev Endocr Metab Disord. 2008;9(1):33-9.
  9. Freda PU, Katznelson L, van der Lely AJ, Reyes CM, Zhao S, Rabinowitz D. Long-acting somatostatin analog therapy of acromegaly: a meta-analysis. J Clin Endocrinol Metab. 2005; 90(8):4465-73.
  10. Colao A, Pivonello R, Auriemma RS, Galdiero M, Savastano S, Lombardi G. Beneficial effect of dose escalation of octreotide-LAR as first-line therapy in patients with acromegaly. Eur J Endocrinol. 2007;157(5):579-87.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2014 Dreval’ A.V., Pokramovich Y.G., Trigolosova I.V., Vinogradova A.V., Ilovayskaya I.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies