Endocrine Abstracts

Objective: The aim of this single centre prospective open trial was to evaluate the long-term efficacy of octreotide LAR in acromegaly patients.

Methods: In total of 19 patients with acromegaly diagnosed at Endocrinology Department of Clinical Centre of University in Sarajevo, somatostatin sensitive (ten females and eight males, age range 40–68 years, six patients with microadenoma and 12 patients with macroadenoma) were treated with octreotide. Follow-up period was 7 years (2009–2016). The concentration of human Growth Hormone (hGH) and insulin-like growth factor-1 (IGF-1) were evaluated every 6 months, while magnetic resonance imaging was taken every year during follow-up period.

Results: During the first year of treatment ten patients were included. In the second year, a further seven patients were involved. During the last 4 years, five patients were included. During the seventh year of follow-up, the treatment was successful discontinued at four patients, two patients was passed away due to co-morbidities and at two another patients’ treatment was cancelled due to cancer; so currently we followed total of 11 patients. One of patient was treated by Gamma Knife radiosurgery and after that developed pituitary deficiency, but he is needed to continue with octreotide treatment because of high hGH and IGF-1 level. During octreotide treatment, significantly reduced GH (50.87±10.56 vs 3,4±0.76 ng/ml, P<0,005), IGF-1 (777.66±118.40 vs 349±97.54 ng/ml, P<0.005) and adenoma size (from 9.6 to 8 mm; P<0.05). GH decrease to less than 1 ng/ml was achieved in 66% of cases; tumour size decrease was achieved in 49%, while normalization of IGF-1 was achieved in 88% of the patients, respectively. At 1–4 years of follow-up, 20% of acromegaly patients had withdrawn treatment, without recurrence. Two patients on octreotide treatment have uncontrolled acromegaly.

Conclusion: Octreotide LAR treatment is effective in decrease of GH, IGF-1 and tumour size in well-selected acromegalic patients.