Intravenous octreotide test predicts the long term outcome of treatment with octreotide-long-acting repeatable in active acromegaly

Biermasz, Nienke R.; Pereira, Alberto M.; Smit, Johannes W. A.; Romijn, Johannes A.; Roelfsema, Ferdinand

doi:10.1016/j.ghir.2005.02.007

Cited by 32 publications

(25 citation statements)

References 37 publications

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“…Mean GH on SAT < 5 mU/l GH nadir following TD < 5 mU/l GH fall > 50% following TD GH fall > 75% following TD Biermasz et al (19) analysed the relationship between the response to the acute test (50 mg i.v. octreotide) and the outcome of 'chronic octreotide LAR treatment' in 18 patients with acromegaly.…”

Section: Discussionmentioning

confidence: 99%

The octreotide test dose is not a reliable predictor of the subsequent response to somatostatin analogue therapy in patients with acromegaly

Pokrajac

Claridge²,

Shakoor³

et al. 2006

eur j endocrinol

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In many centres, a test dose (TD) of octreotide is administered before commencing somatostatin analogue therapy (SAT), although the merits of this procedure are uncertain. We have analysed the value of the GH response to a TD in predicting the efficacy of subsequent SAT in 47 patients with acromegaly (25 male, median age 51 years, range 20-82). The primary goal of SAT was a mean GH of , 5 mU/l. Median baseline GH was 19.3 mU/l (2.2-233 mU/l) and with the TD fell by 78% (35 -98%) to a nadir of 4.2 mU/l (, 0.3-85 mU/l). Optimal predictive power was observed when GH fell to , 5 mU/l after the TD. With this criterion, the TD had a positive predictive value (PPV) of achieving the primary goal on SAT of 82% and a negative predictive value (NPV) of 50%. However, baseline GH was also highly predictive of the likelihood of successful SAT (GH , 5 mU/l). The GH response to the TD had PPV of 83% and NPV of 61% of normalising IGF-I on SAT. In summary, baseline GH and nadir after a TD are highly predictive of a good response to SAT; however, a poor response to a TD does not exclude an optimal response to SAT. Furthermore, failure to achieve biochemical control does not equate to no benefit, as biochemical improvement was seen in every patient; therefore, no patient should be deprived of octreotide therapy because of the result of a TD. In conclusion, our data indicate that the octreotide TD has no place in selecting patients for SAT.European Journal of Endocrinology 154 267-274

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Section: Discussionmentioning

confidence: 99%

The octreotide test dose is not a reliable predictor of the subsequent response to somatostatin analogue therapy in patients with acromegaly

Pokrajac

Claridge²,

Shakoor³

et al. 2006

eur j endocrinol

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“…Also, attaining GH levels below 5 mg/l after 3 months and IGF-I levels below 550 mg/l after 6 months of SA treatment appears to be good positive predictors of long-term control (7). GH suppression test, following a single s.c. injection of octreotide, has been extensively studied with variable results (8)(9)(10)(11)(12)(13)(14)(15). Scintillography with 111 In-pentetreotide (Octreoscan) has also been studied, with limited success at predicting SA-mediated disease control (14,16,17).…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of somatostatin receptor subtypes (1–5) gene expression levels in somatotropinomas and correlation to in vivo hormonal and tumor volume responses to treatment with octreotide LAR

Taboada

Luque

Neto

et al. 2008

European Journal of Endocrinology

162

110

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Objective: To determine whether the somatostatin receptor subtype (SSTR) expression profile correlates with hormonal and tumor volume responses to postsurgical octreotide long acting repeatable (OCT LAR) treatment. Design and methods: Quantitative real-time RT-PCR was used to evaluate the absolute mRNA copy numbers for all five SSTR subtypes in 22 somatotropinomas. Response to OCT LAR was studied by hormone levels (GH and IGF-I) and tumor volume (sella turcica magnetic resonance imaging). Results: SSTR5 was present at the highest level followed by SSTR2, SSTR3, SSTR1, and SSTR4 (2327 (1046-5555), 2098, 97 (0-460), 14 (0-29 480), and 0 (0-652) copies respectively). Positive correlations were found between SSTR2 levels and the percentage decrease of GH and IGF-I after 3 (rZ0.49, P!0.027 and rZ0.49, P!0.029 respectively) and 6 (rZ0.59, P!0.006 and rZ0.58, P!0.008 respectively) months of OCT LAR. A negative correlation was found between SSTR5 mRNA levels and the percentage decrease of GH after 3 months of OCT LAR (rZK0.52, PZ0.016, nZ21). A higher SSTR2/SSTR5 ratio was observed among patients who obtained hormonal control with OCT LAR, when compared with those uncontrolled (2.4 (0.7-10) vs 0.3 (0.1-7.7), PZ0.001). A ROC curve analysis showed a SSTR2/SSTR5 ratio of 1.3 as the best predictor of disease control, with a sensitivity of 88% and a specificity of 92% -area under curve, 0.9. A positive correlation was also found between SSTR2 mRNA levels and the percentage decrease in tumor volume after 6 months of OCT LAR (rZ0.79, PZ0.002, nZ12). Conclusions: Somatostatin receptor subtype 2 mRNA expression levels in somatotropinomas correlate positively with in vivo hormonal and tumor volume responses to OCT LAR. European Journal of Endocrinology 158 295-303

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“…After the long-acting formulations became available, several studies evaluated the efficacy of OST as a predictor of long-term response (shown in Supplementary Table 1). However, the results of different studies were conflicting, but with more publications in favor of using the OST [13][14][15][27][28][29][30][31], than discarding it [7,12,25,32]. The conflicting results might be caused by different OST protocols, octreotide dosages, outcome criteria and various parameters selected for evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, the octreotide suppression test (OST) has become routine practice in many endocrine centers [12], but the value of the OST in predicting long-term response to SSA therapy is still controversial [12][13][14][15]. Moreover, shortterm pre-surgical treatment with SSA in macroadenomas has been supported by a few studies and a recent meta-analysis [16], but it is unclear whether or not the OST can predict the efficacy of SSA after a relatively shorter period of usage, e.g.…”

Section: Abbreviated Parameters and Formulasmentioning

confidence: 99%

The value of an acute octreotide suppression test in predicting short-term efficacy of somatostatin analogues in acromegaly

Wang

Shen

et al. 2016

Endocr J

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Intravenous octreotide test predicts the long term outcome of treatment with octreotide-long-acting repeatable in active acromegaly

Cited by 32 publications

References 37 publications

The octreotide test dose is not a reliable predictor of the subsequent response to somatostatin analogue therapy in patients with acromegaly

The octreotide test dose is not a reliable predictor of the subsequent response to somatostatin analogue therapy in patients with acromegaly

Quantitative analysis of somatostatin receptor subtypes (1–5) gene expression levels in somatotropinomas and correlation to in vivo hormonal and tumor volume responses to treatment with octreotide LAR

The value of an acute octreotide suppression test in predicting short-term efficacy of somatostatin analogues in acromegaly

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