ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (101 abstracts)
Lanreotide autogel may be an effective approach for acromegalic patients who failed octreotide lar
Lucio Vilar 1 , Clarice Vilar 2 , Luciano Albuquerque 1 , Erik Trovao 1 , Ana Carolina Thé 1 , Icaro Sampaio 1 , Liana Ferreira 1 , Izabela Cardoso 1 , Thaise Borges 1 , Priscila Aroucha 1 , Patricia Gadelha 1 & Ruy Lyra 1
1Division of Endocrinology, Hospital das Clinicas, Federal University of Pernambuco, Recife, Brazil; 2Pernambuco Endocrine Research Center, Recife, Brazil.
Background: Growth hormone secreting pituitary gland adenomas specifically express somatostatin (SST)-2 and SST5 receptors. First-generation somatostatin analogs (octreotide and lanreotide) are the mainstay in the medical treatment of acromegaly, however the percentage of patients controlled with these drugs significantly varies in the different studies (20–70%). Many factors are involved in the resistance to SRL somatostatin analogs such as sst, AIP, E-cadherin, ZAC1, filamin A and β-arrestin expression in the somatotropinomas. With a higher affinity for the SST2 receptors and low affinity for the SST-5 ones, octreotide and lanreotide are thought to have a similar efficacy in normalizing IGF-1 and GH levels. However, their exact dose equivalence is not yet fully established.
Objective: To evaluate the effectiveness of Lanreotide autogel (LAN) 120 mg monthly in normalizing GH and IGF-1 levels in acromegalic patients who failed octreotide LAR (OCT-LAR) 30 mg monthly concerning hormonal normalization. These doses have usually been considered the maximal doses of these agents.
Subjects and methods: Twenty four patients (14 men and 10 women; mean age 42.3±10.2 years [range, 25–62 years]) who do not reach normalization of IGF-1 levels while taking OCT-LAR 30 mg every 4 weeks intramuscularly were enrolled. These patients have been previously treated with OCT-LAR only (n=15) or OCT-LAR combined with cabergoline (n=9). They were given subcutaneous injections of LAN 120 mg every 4 weeks instead of OCT-LAR. The clinical and biochemical responses of patients were evaluated 3 months later.
Results: After 3 months of LAN treatment, normalization of IGF-1 levels and GH levels < 1 ng/ml were observed in 6 patients (25%). The response rate did not differ in patients previously submitted to OCT-LAR monotherapy or those receiving combined therapy. The LAN tolerability profile was similar to that of OCT-LAR.
Conclusion: Our results indicate that monthly injections of 120 mg of Lanreotide autogel may be an effectivel approach for one quarter of acromegalic patients partially responsive to 30 mg of OCT-LAR monthly.
Volume 56
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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