This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cozzi, R. Articles by Pedroncelli, A. M. Search for Related Content PubMed PubMed Citation Articles by Cozzi, R. Articles by Pedroncelli, A. M.

Four-Year Treatment with Octreotide-Long-Acting Repeatable in 110 Acromegalic Patients: Predictive Value of Short-Term Results?

Division of Endocrinology, Ospedale Niguarda (R.C., R.A., M.B., D.D.), I-20162 Milan, Italy; Endocrine Unit, Ospedali Riuniti (M.M., G.P., M.A., A.M.P.), Bergamo I-24100, Italy; and Department of Neurosurgery, Carlo Besta Institute (G.L., S.L.), Besta I-20133, Milan, Italy

Address all correspondence and requests for reprints to: Dr. R. Cozzi, Viale Ezio 5, I-20149 Milan, Italy. E-mail: renatocozzi{at}tiscali.it.

The effects of a very prolonged treatment with octreotide (OC)-long-acting repeatable (LAR) were retrospectively evaluated in 110 patients with acromegaly, showing a GH/IGF-I decrease of at least 20% vs. baseline after a short-term (6-month) OC-LAR challenge. OC-LAR was given (20 mg, im, every 28 d for 3 injections, then individually tailored) as adjuvant treatment (AT) in 59. The other 51 [primary treatment (PT)] were naive or previously treated by pharmacotherapy. IGF-I normalized in 83 patients [75%; from 770 ± 26 (mean ± SE) to 276 ± 15 µg/liter; P < 0.0001; median follow-up, 30 months; range, 18–54 months). A progressive increase in the rate of IGF-I normalization was observed. GH fell to less than 2.5 µg/liter in 72% and to less than 1 µg/liter in 27% (from 20.7 ± 2.4 to 2.2 ± 0.2 µg/liter; P < 0.0001). PT and AT patients achieved similar final GH/IGF-I levels and rates of normalization. Patients attaining safe GH and normal IGF-I had GH levels below 5 µg/liter after 3 months and IGF-I levels below 550 µg/liter after 6 months. No tachyphylaxis was observed. The up-titration to 30 mg improved IGF-I suppression. Elderly patients had greater sensitivity. Tumor shrank in 46% of assessable patients, in 77% of PT patients, and in 91% of naive patients. The powerful suppression of GH/IGF-I levels without tachyphylaxis, the finding of progressive increase in the rate of IGF-I normalization and of superimposable effects in PT and AT patients, and the predictive value of short-term results support the role of PT of acromegaly with OC-LAR in at least some patients.

Abbreviations: AT, Adjuvant treatment; LAN, lanreotide-SR; LAR, long-acting repeatable; MRI, magnetic resonance imaging; OC, octreotide; PT, primary treatment; ROC, receiver-operating characteristic; RT, radiotherapy; SA, somatostatin analog; NS, neurosurgery; %ULNR, percentage of upper limit of normal range.

This article has been cited by other articles:

				A. Colao, R. S. Auriemma, M. Galdiero, G. Lombardi, and R. Pivonello Effects of Initial Therapy for Five Years with Somatostatin Analogs for Acromegaly on Growth Hormone and Insulin-Like Growth Factor-I Levels, Tumor Shrinkage, and Cardiovascular Disease: A Prospective Study J. Clin. Endocrinol. Metab., October 1, 2009; 94(10): 3746 - 3756. [Abstract] [Full Text] [PDF]

				N. Moller and J. O. L. Jorgensen Effects of Growth Hormone on Glucose, Lipid, and Protein Metabolism in Human Subjects Endocr. Rev., April 1, 2009; 30(2): 152 - 177. [Abstract] [Full Text] [PDF]

				A. Colao, R. Pivonello, R. S. Auriemma, M. Galdiero, S. Savastano, L. F. S. Grasso, and G. Lombardi Growth Hormone-Secreting Tumor Shrinkage after 3 Months of Octreotide-Long-Acting Release Therapy Predicts the Response at 12 Months J. Clin. Endocrinol. Metab., September 1, 2008; 93(9): 3436 - 3442. [Abstract] [Full Text] [PDF]

				R. D. Murray and S. Melmed A Critical Analysis of Clinically Available Somatostatin Analog Formulations for Therapy of Acromegaly J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2957 - 2968. [Abstract] [Full Text] [PDF]

				G. F Taboada, R. M Luque, L. V. Neto, E. d. O Machado, B. C Sbaffi, R. C Domingues, J. B Marcondes, L. M C Chimelli, R. Fontes, P. Niemeyer, et al. Quantitative analysis of somatostatin receptor subtypes (1-5) gene expression levels in somatotropinomas and correlation to in vivo hormonal and tumor volume responses to treatment with octreotide LAR Eur. J. Endocrinol., March 1, 2008; 158(3): 295 - 303. [Abstract] [Full Text] [PDF]

				S. J. C. M. M. Neggers, M. O. van Aken, J. A. M. J. L. Janssen, R. A. Feelders, W. W. de Herder, and A.-J. van der Lely Long-Term Efficacy and Safety of Combined Treatment of Somatostatin Analogs and Pegvisomant in Acromegaly J. Clin. Endocrinol. Metab., December 1, 2007; 92(12): 4598 - 4601. [Abstract] [Full Text] [PDF]

				A. Colao, R. Pivonello, R. S Auriemma, M. Galdiero, S. Savastano, and G. Lombardi Beneficial effect of dose escalation of Octreotide-LAR as first-line therapy in patients with acromegaly Eur. J. Endocrinol., November 1, 2007; 157(5): 579 - 587. [Abstract] [Full Text] [PDF]

				G. F Taboada, R. M Luque, W. Bastos, R. F C Guimaraes, J. B Marcondes, L. M C Chimelli, R. Fontes, P. J P Mata, P. N. Filho, D. P Carvalho, et al. Quantitative analysis of somatostatin receptor subtype (SSTR1-5) gene expression levels in somatotropinomas and non-functioning pituitary adenomas Eur. J. Endocrinol., January 1, 2007; 156(1): 65 - 74. [Abstract] [Full Text] [PDF]

				C Susini and L Buscail Rationale for the use of somatostatin analogs as antitumor agents Ann. Onc., December 1, 2006; 17(12): 1733 - 1742. [Abstract] [Full Text] [PDF]

				A. Colao, R. Pivonello, R. S. Auriemma, F. Briganti, M. Galdiero, F. Tortora, F. Caranci, S. Cirillo, and G. Lombardi Predictors of Tumor Shrinkage after Primary Therapy with Somatostatin Analogs in Acromegaly: A Prospective Study in 99 Patients J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2112 - 2118. [Abstract] [Full Text] [PDF]

				R. Cozzi, M. Montini, R. Attanasio, M. Albizzi, G. Lasio, S. Lodrini, P. Doneda, L. Cortesi, and G. Pagani Primary Treatment of Acromegaly with Octreotide LAR: A Long-Term (Up to Nine Years) Prospective Study of Its Efficacy in the Control of Disease Activity and Tumor Shrinkage J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1397 - 1403. [Abstract] [Full Text] [PDF]

				A. Colao, R. Attanasio, R. Pivonello, P. Cappabianca, L. M. Cavallo, G. Lasio, A. Lodrini, G. Lombardi, and R. Cozzi Partial Surgical Removal of Growth Hormone-Secreting Pituitary Tumors Enhances the Response to Somatostatin Analogs in Acromegaly J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 85 - 92. [Abstract] [Full Text] [PDF]

				C. L. Ronchi, V. Varca, P. Beck-Peccoz, E. Orsi, F. Donadio, A. Baccarelli, C. Giavoli, E. Ferrante, A. Lania, A. Spada, et al. Comparison between Six-Year Therapy with Long-Acting Somatostatin Analogs and Successful Surgery in Acromegaly: Effects on Cardiovascular Risk Factors J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 121 - 128. [Abstract] [Full Text] [PDF]

				S Melmed, F Casanueva, F Cavagnini, P Chanson, L A Frohman, R Gaillard, E Ghigo, K Ho, P Jaquet, D Kleinberg, et al. Consensus statement: medical management of acromegaly Eur. J. Endocrinol., December 1, 2005; 153(6): 737 - 740. [Abstract] [Full Text] [PDF]

				P. U. Freda, L. Katznelson, A. J. van der Lely, C. M. Reyes, S. Zhao, and D. Rabinowitz Long-Acting Somatostatin Analog Therapy of Acromegaly: A Meta-Analysis J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4465 - 4473. [Abstract] [Full Text] [PDF]

				W. W de Herder, H R. Taal, P. Uitterlinden, R. A Feelders, J. A M J L Janssen, and A.-J. van der Lely Limited predictive value of an acute test with subcutaneous octreotide for long-term IGF-I normalization with Sandostatin LAR in acromegaly Eur. J. Endocrinol., July 1, 2005; 153(1): 67 - 71. [Abstract] [Full Text] [PDF]

				N. R. Biermasz, A. M. Pereira, J. W. A. Smit, J. A. Romijn, and F. Roelfsema Morbidity after Long-Term Remission for Acromegaly: Persisting Joint-Related Complaints Cause Reduced Quality of Life J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2731 - 2739. [Abstract] [Full Text] [PDF]

				D. Selvarajah, J. Webster, R. Ross, and J. Newell-Price Effectiveness of adding dopamine agonist therapy to long-acting somatostatin analogues in the management of acromegaly Eur. J. Endocrinol., April 1, 2005; 152(4): 569 - 574. [Abstract] [Full Text] [PDF]

				J. S. Bevan The Antitumoral Effects of Somatostatin Analog Therapy in Acromegaly J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1856 - 1863. [Abstract] [Full Text] [PDF]

				I. E Bonapart, R. van Domburg, S. M T H ten Have, W. W de Herder, R. A M Erdman, J. A M J L Janssen, and A. J. van der Lely The 'bio-assay' quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-I concentrations Eur. J. Endocrinol., February 1, 2005; 152(2): 217 - 224. [Abstract] [Full Text] [PDF]

				J. Ayuk, M. C. Sheppard, R. N. Clayton, A. S. Bates, and P. M. Stewart Evidence for the Use of IGF-I as a Predictor of Mortality in Acromegaly Is Lacking J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5867 - 5868. [Full Text] [PDF]

				R. Attanasio, R. Baldelli, R. Pivonello, S. Grottoli, L. Bocca, V. Gasco, M. Giusti, G. Tamburrano, A. Colao, and R. Cozzi Lanreotide 60 mg, a New Long-Acting Formulation: Effectiveness in the Chronic Treatment of Acromegaly J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5258 - 5265. [Abstract] [Full Text] [PDF]