Monotherapy with lanreotide depot for acromegaly: long-term clinical experience in a pituitary center.

Abstract

PURPOSE:

Long-acting somatostatin analogs are one of the main classes of medical therapy used for acromegaly and most patients require ongoing treatment. Few studies have evaluated the long-term efficacy and safety of lanreotide depot beyond 2 years. The goal of this study was to provide a long-term longitudinal assessment of efficacy and safety of lanreotide depot in lanreotide responders compared to a surgically cured control group.

METHODS:

In this retrospective longitudinal case-control study, patients with acromegaly receiving lanreotide depot monotherapy continuously for at least 24 months (N = 24) and surgically cured patients (N = 39) were compared. Serum IGF-1, pituitary MRIs, lanreotide dose, co-morbidities and adverse effects were assessed longitudinally.

RESULTS:

In the lanreotide group, IGF-1 remained normal and unchanged over 6 years; comparable to the surgery only group. There was no difference in prevalence of normal IGF-1 between the lanreotide and surgery only groups at 6 months (100 vs. 97 %), 6 years (89 vs. 90 %) and at last follow-up (96 vs. 92 %). Tumor size remained stable (79 %) or decreased (21 %) in the lanreotide group. In the surgery only group, tumor size remained unchanged in all patients. Hemoglobin A1C did not differ between lanreotide and surgery only groups (baseline 5.8 vs. 6.1 %; last follow-up 6.0 vs. 5.7 %). Two (8 %) of the lanreotide and none of the surgery only group developed new diabetes mellitus.

CONCLUSION:

Lanreotide depot maintains normalization of IGF-1 in 89 % of responders after 6 years, comparable to surgically cured controls, and controlled tumor size in all without significant adverse effects.

• Authors: Babak Torabi Sagvand, Shafaq Khairi, Arezoo Haghshenas, Brooke Swearingen, Nicholas A Tritos, Karen K Miller, Anne Klibanski, Lisa B Nachtigall
• Journal: Pituitary (Pituitary) Vol. 19 Issue 4 Pg. 437-47 (Aug 2016) ISSN: 1573-7403 [Electronic] United States
• PMID: 27155600 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Delayed-Action Preparations
• Peptides, Cyclic
• lanreotide
• Somatostatin
• Insulin-Like Growth Factor I

Topics

• Adenoma (drug therapy, metabolism)
• Antineoplastic Agents (therapeutic use)
• Case-Control Studies
• Chemotherapy, Adjuvant
• Delayed-Action Preparations
• Female
• Growth Hormone-Secreting Pituitary Adenoma (drug therapy, metabolism)
• Humans
• Insulin-Like Growth Factor I (metabolism)
• Male
• Middle Aged
• Neurosurgical Procedures
• Peptides, Cyclic (therapeutic use)
• Retrospective Studies
• Somatostatin (analogs & derivatives, therapeutic use)