Endocrine Abstracts

Treatment of acromegalic patients with somatostatin analogues decreases hGH and IGF1 concentrations, improves general and metabolic conditions and decreases morbidity and mortality in these patients. We assessed the efficacy of octreotide LAR (SSLAR) in treating acromegalic patients following non-radical surgery of pituitary adenoma at a single centre.

Materials and methods: At our Centre we follow 85 acromegalic patients who underwent surgery, including 47 patients (29 female and 18 male, of mean age 41.1±14.9 years) who required further treatment with SSLAR due to non-radical surgery. Within this group 44 patients presented with macroadenoma and 3 with microadenoma. Following surgery, concentrations of hGH in OGTT and IGF1 were measured to evaluate the result of surgery, and repeated 3, 6, 12, 18 and 24 months later. Basic statistics, Shapiro–Wilk and Wilcoxon tests, and ANOVA Friedman test, using the Statistica software, were applied.

Results: Following surgery, respective median values of hGH and IGF1 concentrations were 5.65 ng/ml (min 1.7; max 43.5) and 520.0 ng/ml (min 154.0; max 1135.0). After 6, 12, and 24 months of SSLAR treatment median values of hGH significantly decreased (P<0.05) to 3.3 ng/ml (min 0.9; max 95.9), 3.15 ng/ml (min 0.65; max 49.0) and 2.35 ng/ml (min 0.8; max 50.0), respectively. The differences between median hGH concentrations at 12 and 24 months were statistically significant (P<0.05). After 6, 12, and 24 months of SSLAR treatment respective median IGF1 concentrations also decreased to 384.5 ng/ml (min 146.0; max 1645.0), 316.0 ng/ml (min 114.8; max 840.0) and 404.6 ng/ml (min 174.4; max 1235.0) which were statistically significant (P<0.05) against the value prior to SSLAR treatment. After 6 months of SSLAR treatment, hGH<2.5 ng/ml and IGF1 normalization were achieved in 36.4 and 44.4% of patients, respectively. After 24 months of SSLAR treatment, hGH<2.5 ng/ml and IGF1 normalization were achieved in 54.8 and 53.3% of patients, respectively.

Conclusions: (i) Long-term SSLAR treatment of non-radically operated acromegalic patients is advisable as its efficacy improves with time; (ii) We believe that the predomination of pituitary macroadenoma in our patient group (93%) has negatively biased our results.