Endocrine Abstracts

Aim: To assess the relationship between clinical symptoms, growth hormone (GH) and IGF-1 during medical treatment for acromegaly.

Methods and Patients: 6 patients, mean age 52y, (range 43-68), 4 males, were treated with Lanreotide SR (LAN). A growth hormone day curve (GHDC) and IGF-1 were assessed at week 0, pre LAN. All patients received LAN 30mg, 2weekly. GHDC was repeated at week 8, aiming for mean growth hormone (MGH) <5mu\/l. LAN was increased to weekly injections if MGH >5mu/l. A repeat profile was performed at week 16. A visual analogue symptom scale, ranging from 0 (no symptoms) to 10 (severe symptoms) was completed by all patients at weeks 0, 8 and 16.

Results: At diagnosis, all patients were symptomatic with mean score: Sweating-5.5, Headache-3.19, Joint pain-5.19, Tissue swelling-5.05. Symptoms improved with LAN treatment in the 5/6 LAN responders. Mean score at 16 weeks: Sweating 1.53, Headache- 1.75, Joint pain 1.33, Soft tissue swelling 1.91. Although individual assessment of excessive sweating and soft tissue swelling correlated very well with MGH (r=0.9, r=0.99), there was a less clear relationship between headaches and joint pain with MGH (r=0.68, r=0.85). There was no relationship between mean arterial blood pressure and GH/IGF-1 during treatment. In 2/6 patients, IGF-1 and MGH were discordant for at least 2 time points.

Conclusion: Sweating and tissue swelling are closely related to disease control in patients with acromegaly, whereas headaches and joint pain are less so. Assessment of treatment efficacy on the basis of IGF-1 alone needs further study.