Endocrine Abstracts

The last decade has provided major progress in the development of highly specific and selective pharmacological agents that have facilitated a more aggressive approach to the treatment of patients with acromegaly. Initial transsphenoidal surgery still appears to be the first line of treatment, but in many cases the biochemical cure targets are not reached and the patient needs adjuvant therapy. Somatostatin analogues have become the mainstay of the medical treatment of acromegaly, with dopamine agonists and GH-receptor antagonists as an alternative medication.

This is our experience regarding two patients treated with Octreotide.

First patient (29-year-old male) was diagnosed with acromegaly in September 2004 and in the same year transsphenoidal surgery was performed. From January 2008 we started Lanreotide (Somatuline) 30 mg/14 days for 12 months, a period in which his GH levels increased from 17, 5 μg/l to 42 μg/l and his IGF1 levels from 550 ng/ml to 917 ng/ml. We decided to change the somatostatin analogue and from July 2009 he received Octreotide (Sandostatin LAR) 20 mg/28 days. After 6 months of treatment his GH and IGF1 levels significantly decreased (IGF1 by 55% and GH by 70%).

The second patient (26-year-old-male) had a GH level of 52 μg/l and an IGF1 level of 839 ng/ml at the time of diagnosis. After 6 months of therapy with Octreotide (Sandostatin LAR) 20 mg/28 days both of them decreased (IGF1 by 70% and GH by 80%).

The patients with acromegaly who are not responding to Somatuline therapy may benefit from Sandostatin LAR treatment. This is also a good option for the young patients, where fertility is a priority.