Twelve patients with active acromegaly, six of whom had not responded to previous combined surgery, radiotherapy, and bromocriptine administration, were treated with an octapeptide long-acting somatostatin analogue, SMS 201-995, given subcutaneously for up to 1 year. Growth hormone (GH) levels decreased by 50% to 90% after a single 25-micrograms SMS 201-995 injection in all patients, including two who were resistant to bromocriptine therapy. After GH values reached a nadir, they returned to preinjection values over a 12-hour period and no rebound was seen. Assessment of the GH-lowering effect of the drug at weekly intervals for the first 6 weeks and monthly thereafter disclosed no tachyphylaxis. Gradual increase of the dose from 50 to 150 micrograms daily led to a significant increase in clinical improvement. Shrinkage of the size of the pituitary tumor was documented in three of nine evaluated cases. Abdominal cramps of a transient nature not associated with diarrhea were noted in two patients but there were no other side effects. Hematological and biochemical blood and urine tests, including serum thyroxine and cortisol levels, did not reveal any abnormality during chronic treatment. This study demonstrates the safety and efficacy of SMS 201-995 in the short-term treatment of acromegaly.

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SUMMARY The results obtained with a new test of prolactin (PRL) release in six panhypo‐pituitary patients as compared to fourteen normal subjects (eight females and six males) are presented. The test consists of the i.m. administration of 100 mg of sulphide and the measurement of plasma PRL by a double antibody radio‐immunoassay techniques at −15, 0, 15, 30, 45, 60, 75, 90, 105 and 120 min. Mean baseline PRL values were not significantly different in the three groups. After sulpiride a 800–4200% increment of prolactin over control values was noted in the females and 1200–3500% increment in the males. The peak values were obtained at 15 or 30 min (6030·670 mu/l ± SEM in the females and 5550·870 mu/l in the males). The mean values were not significantly different in the two sexes until the sixtieth minute but were significantly higher (P > 0.05) in the female thereafter. In the hypopituitary patients a complete failure of response was noted. These results show that the sulpiride test possesses a considerable potential as a screening procedure in the diagnosis of pituitary insufficiency.

We report here the results obtained with a new test of prolactin (PRL) release in six normal pre-pubertal boys, eleven children with short stature of non-pituitary origin and in thirteen pituitary dwarfs. The test consists of the administration of 100 mg of sulpiride i.m. and the measurement of PRL in serum samples up to 120 min after injection. Baseline PRL concentrations were not clearly different in the three groups. After sulpiride a marked increase (3--10 times over control values) in PRL was noted in all normal and short children without pituitary disease. A complete failure of response was observed in ten of the thirteen pituitary dwarfs. It is concluded that sulpiride has considerable potential in the differential diagnosis of children with stunted growth.