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Three Year Follow-Up of Acromegalic Patients Treated with Intramuscular Slow-Release Lanreotide¹

Department of Endocrinology (Ph.C., M.C.), CHU Rangueil, Toulouse; Department of Endocrinology (I M-R, Ph J), CHU la Timone, Marseilles, France

Address all correspondence and reprint requests to: Dr Philippe Caron, Service d’Endocrinologie et Maladies métaboliques, CHU Rangueil, 1, Avenue J. Poulhés, 31054 Toulouse Cedex, France.

Somatostatin analogs are an alternative treatment to pituitary surgery and radiotherapy in acromegalic patients. Recently, a depot long-lasting formulation of slow release (SR) lanreotide has been shown to be effective in the short-term control of GH hypersecretion in acromegalic patients. We report the long-term follow-up of a cohort of 22 acromegalic patients treated with SR lanreotide during 1–3 yr. Thirteen females and 9 males, age 51 ± 3 yr, presented with macroadenomas (n = 12), microadenomas (n = 8), or empty sella (n = 2). Seven patients previously had undergone a partial surgical removal of their adenomas, and 21 of them had mean plasma GH levels less than 5 µg/L during a previous octreotide treatment. According to GH values recorded after 3 months of twice monthly 30 mg SR lanreotide im injection, SR lanreotide was administered every 14 days (n = 13) or every 10 days (n = 9). At the 6-month visit, mean GH values were 5 µg/L or less in 68% and 2.5 µg/L or less in 27% of patients, and these results remained unchanged during the 1–3 yr follow-up period. During SR lanreotide treatment, the mean insulin-like growth factor I (IGF-I) concentrations remained in the normal range in 63% of patients. No escape from the treatment occured in any of the cases. A significant decrease of the pituitary tumor volume was observed in 3 (13%) patients. The main side effect consisted of minor digestive problems during 48 h after each injection and was reported by 13 patients. Biannual gallbladder echographies revealed the occurence of gallstones in 4 (18%) patients. In conclusion, these data confirm the efficacy and the tolerance of the long-term SR lanreotide administration (30 mg im every 10–14 days) in the control of acromegaly.

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