The use of
somatostatin analogues for the treatment of
acromegaly is now well established. Recently long-acting preparations of
octreotide and
lanreotide have been introduced. In this study we have assessed the efficacy and tolerability of the long acting
somatostatin analogue
octreotide LAR in patients with
acromegaly, and compared it with
lanreotide SR. Five patients with active
acromegaly were recruited; they were treated with
lanreotide SR for 6 months and then, following a wash-out period, received
octreotide LAR for 6 months. They were assessed at baseline, 3- and 6-months, by clinical score, GH and IGF1. Adverse effects were carefully monitored. Both treatments effectively reduced GH and IGF1 levels. Four of five patients achieved a mean GH level of < 2.5 ng/ml with both drugs; with
octreotide LAR only, these patients also had GH < 1 ng/ml after oral
glucose loading. The clinical symptoms score improved significantly with
octreotide LAR, as did the ring size; the clinical score correlated significantly with GH.
Blood glucose was not adversely affected. All patients experienced minor GI symptoms with
lanreotide SR, but less frequently with
octreotide LAR. Both drugs caused
biliary stasis and had a tendency to form biliary sludge.
Octreotide LAR proved effective for the treatment of
acromegaly and was well tolerated.
Octreotide LAR had some advantages over
lanreotide SR, although the differences were not great.