ECE2008 Poster Presentations Neuroendocrinology (107 abstracts)
Starting dose of 10 mg Octreotide-LAR appears ineffective for biochemical control in the majority of acromegalic patients: interim analysis from the OASIS trial
Stephan Petersenn 1 , Alexander Tarasov 2 , Feng Gu 3 , Sungwoon Kim 4 , Moises Mercado 5 , Amelia Rogozinski 6 , Hakim Bouterfa 7 , Kristin David 8 , Antonio Silva 7 & Yona Greenman 9
1Division of Endocrinology, Medical Center, University of Duisburg-Essen, Essen, Germany; 2Regional Endocrinology Center, Ekaterinburg, Russian Federation; 3Peking Union Medical College Hospital, Beijing, China; 4Kyung Hee University, Seoul, Korea; 5Endocrinology Service, Centro Medico Nacional Siglo XXI, Hospital de Especialidades, IMSS, Mexico City, Mexico; 6Endocrinology Consulting Office, Buenos Aires, Argentina; 7Novartis Pharma AG, Basel, Switzerland; 8ProSanos Corporation, Harrisburg, Pennsylvania, USA; 9Tel Aviv Medical Center, Tel Aviv, Israel.
Octreotide LAR (SMS-LAR) is available in 10, 20 and 30 mg dosing. The relation-ship between SMS-LAR starting dose and GH, IGF-I and symptoms was exam-ined. The Observational Acromegaly Study on Impact of Sandostatin LAR (OASIS) collects data on GH, IGF-I, symptoms, safety and tolerability in recently diagnosed acromegalic patients. Data are collected under normal practice conditions over 12 mos. Eight hundred and sixty patients from 138 centers in 23 countries are enrolled; 353 patients have data available for analysis. One hundred and fifty patients (mean age 48 years, 75.3% with a macro-adenoma) started the study with SMS-LAR treatment. Eighty-three percentage started with 20 mg SMS-LAR, 10% (n=15 pts) with 10 mg, 7% with 30 mg and one patient with 40 mg. Patients with 30 mg starting dose had the highest GH and IGF-I levels at treatment start, patients with 10 mg had the lowest (Table). GH mean levels were significantly different for the 10 mg and 20 mg groups (P<0.01) and tended to be different for IGF-I (P=0.06). IGF-I levels were significantly different for the 20 mg and 30 mg groups (P=0.01). Twelve of the 10 mg starting dose patients had efficacy information at 3 month evaluation, of those 82% were not biochemically controlled. Only half of those uncontrolled were up-titrated to 20 mg. Prevalence of any symptoms at treat-ment start was highest in the 30 mg group (90%) followed by 20 mg (83.7%) and 10 mg (80%) (P=0.88). In conclusion, higher starting doses of SMS-LAR are asso-ciated with higher GH and IGF-I levels, suggesting that biochemical parameters, drive the choice of SMS-LAR starting dose. Starting dose of 10 mg appears ineffective for biochemical control in the majority of acromegalic patients.
| SMS-LAR start dose (mgs) | Mean GH±S.D. (ng/ml) | Mean IGF-I±S.D. (ng/ml) |
| 10 | 10.3±9.5 | 583±313 |
| 20 | 22.4±37.0 | 800±398 |
| 30 | 23.7±20.2 | 1149±525 |
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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