Endocrine Abstracts

Introduction: Somatostatin analogues (SSA) present the treatment of choice in patients with previously poorly controlled acromegaly.

Methods: We conducted a retrospective analysis of acromegalic patients enrolled in the Network of Excellence for Neuroendocrine Tumors Munich and treated with the SSA lanreotide.

Results: Fifty-six acromegalic patients (25 females; mean age 59 years; 33 with macroadenoma) switched to lanreotide from previous medical therapies for acromegaly (n=33; 19 due to insufficient biochemical control, 14 due to poor treatment tolerability) (n=11 switch from dopamine agonists, n=15 switch from octreotide, n=3 switch from pegvisomant, and n=4 switch from combination therapy) or were medically treatment-naïve (n=23). Of the 56 patients, 29 patients started on 60 mg, four patients started on 90 mg, and 20 patients started on 120 mg lanreotide; three patients started on combination therapy with dopamine agonists or pegvisomant. Mean follow-up time on lanreotide were 4.6±4.6 years. Lanreotide led to clinical improvement of acromegalic signs and symptoms in 96%. Mean GH concentration decreased from 10.5±25.9 to 3.2±4.9 ng/ml after 3–6 months (P=0.017) and to 2.6±3.2 ng/ml (P<0.001) at the last evaluation on lanreotide (GH ≤2.5 ng/ml in 44 and GH ≤1.0 ng/ml in 37 patients). Mean IGF1 concentration decreased from 1.6±1.0 to 1.1±0.5 xULN after 3–6 months (P<0.001) and to 0.8±0.3 xULN (P<0.001) at the last evaluation on lanreotide. Acromegaly was biochemically controlled in 20 and 73% of patients at baseline and at the last evaluation on lanreotide respectively. Additionally, lanreotide had significant favorable impact on patients’ glycemic status, leading to significant decrease of fasting plasma glucose after 3-6 months of treatment (157.4±141 mg/dl vs 106.9±20.9 mg/dl; P<0.001). Lanreotide was well tolerated with the exception of transient mild gastrointestinal discomfort in 21%.

Conclusion: The SSA lanreotide alone or in combination is safe, effective and well-tolerable in the treatment of previously poorly controlled acromegaly.

Disclosure: This work was supported by an independent research grant from IPSEN.