Effects of treatment with octreotide in acromegalic patients--a multicenter Italian study. Italian Multicenter Octreotide Study Group.

Abstract

Treatment of acromegaly is effective in reversing the reduced life-span of patients only when serum growth hormone (GH) concentrations are lowered to less than 2.5 micrograms/l. Usual treatments achieve this goal in no more than 50-60% of patients. The effects of octreotide were studied in a prospective, open label study with 68 acromegalic patients enrolled in 10 Italian centers. Octreotide was administered sc at a dose of 100 micrograms t.i.d. for 1 year. After 3 months of therapy, octreotide was effective in decreasing serum GH levels below 2.5 micrograms/l in 16 out of 64 acromegalic patients (25%). Fifteen of them had pretreatment GH levels below 25 micrograms/l. Insulin-like growth factor I (IGF-I) levels normalized in about 40% of patients. No further GH reduction was observed after 1 year of treatment. The presence of abnormal GH responses to thyrotropin-releasing hormone (TRH) and gonadotropin-releasing hormone was reduced from 54 to 24% and from 16 to 12%, respectively. Tumor shrinkage was observed in 50% of 26 non-irradiated patients after 12 months of treatment. Both basal and TRH-stimulated serum prolactin levels significantly decreased in the 11 hyperprolactinemic patients. Although serum thyrotropin, free triiodothyronine and free thyroxine concentrations were not modified, a significant reduction of thyrotropin response to TRH was observed in the 9th month of therapy. In non-diabetic patients, an increase of mean blood glucose levels without modifications of fasting morning concentrations was found. About one-quarter of the patients with overt diabetes mellitus had an impairment of their metabolic control. Main clinical symptoms of acromegaly improved in 70-80% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: M Arosio, S Macchelli, C M Rossi, G Casati, O Biella, G Faglia
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 133 Issue 4 Pg. 430-9 (Oct 1995) ISSN: 0804-4643 [Print] England
• PMID: 7581966 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Insulin
• Gonadotropin-Releasing Hormone
• Thyrotropin-Releasing Hormone
• Insulin-Like Growth Factor I
• Prolactin
• Growth Hormone
• Octreotide

Topics

• Acromegaly (blood, complications, drug therapy)
• Adenoma (drug therapy, pathology)
• Adult
• Blood Glucose (metabolism)
• Diabetes Complications
• Diabetes Mellitus (blood)
• Female
• Glucose Tolerance Test
• Gonadotropin-Releasing Hormone
• Growth Hormone (blood)
• Humans
• Insulin (blood)
• Insulin-Like Growth Factor I (metabolism)
• Italy
• Male
• Middle Aged
• Octreotide (adverse effects, therapeutic use)
• Pituitary Neoplasms (drug therapy, pathology)
• Prolactin (metabolism)
• Prospective Studies
• Thyroid Gland (diagnostic imaging, physiopathology)
• Thyrotropin-Releasing Hormone
• Ultrasonography