Endocrine Abstracts

The use of Sandostatin analogues for the treatment of acromegaly is now widely accepted practice for use as an effective method of reducing growth hormone levels to normal, either as primary therapy or prior to or post surgery.

An audit was carried out on 11 patients who had been commenced on monthly depot injections of Sandostatin LAR over a 12 month period. Patients notes were used to obtain information regarding, date of diagnosis, presenting features/symptoms, MRI results, the presence or not of hypertension and diabetes and their initial growth hormone and IGF-1 levels.

All patients were identified as having enlarged hands/feet as their initial presenting feature. 4 were hypertensive and 3 were diabetic. 7 patients underwent surgery for removal of tumour within 2 years of initial diagnosis. 6 received radiotherapy, 9 were treated with sub-cutaneous Sandostatin and 4 were treated initailly another form of medical therapy.

Since commencement of Sandostatin LAR, all patients underwent a 4 hour long fasted growth hormone profile to assess LAR dosage and effects of treatment. 8 patients showed a decrease in their growth hormone levels when compared to pre Sandostatin LAR treatment. 6 patients acheived mean growth hormone levels below the set criteria of 2mu/l. 2 patients did not show any improvements with the use of LAR and were subsequently referred for surgery. 3 patients who had shown a reduction in growth hormone levels, but who failed to reduce levels below 5mu/l had their monthly dosage increased. 1 patient had his dosage reduced and was trouble by the return of nasal polyps.

Overall management of this medical therapy needs fine tuning and regular assessment of treatment outcomes.