Lanreotide 60 mg, a New Long-Acting Formulation: Effectiveness in the Chronic Treatment of Acromegaly

Attanasio, Roberto; Baldelli, Roberto; Pivonello, Rosario; Grottoli, Silvia; Bocca, Liliana; Gasco, Valentina; Giusti, Massimo; Tamburrano, G.; Colao, Annamaria; Cozzi, Renato

doi:10.1210/jc.2003-030266

Cited by 71 publications

(52 citation statements)

References 31 publications

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“…We observed a slight but significant decrease in tumour volume over the 6 month study period, yet it would be unwise to attribute this effect to the change in treatment since we do not know whether the tumour volume was stable or still decreasing before the switch from one analogue to the other. In fact, the effects of any treatment on tumour size should be evaluated in de novo patients or after a longer period of treatment (25,36,37).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Alexopoulou¹,

Abrams

Verhelst

et al. 2004

European Journal of Endocrinology

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Objective: This open label, multicentre study was designed to evaluate the efficacy and tolerability of lanreotide Autogel (L-Autogel) in acromegalic patients over a 24-week period. The outcome of treatment with this new, long-acting, aqueous formulation of lanreotide was also compared with the patients' previous treatment with octreotide long acting repeatable (LAR). Design and methods: Twenty-five acromegalic patients (13 males, mean age 51^12 years) were switched from octreotide LAR (20-40 mg/4 weeks for at least 6 months) to L-Autogel, given deep subcutaneously at a fixed dose of 90 mg/4 weeks. After 12 weeks, the dose of L-Autogel was titrated according to patients' mean GH and IGF-I levels at week 8. It was increased to 120 mg/4 weeks if GH . 2.5 mg/l or if IGF-I was above the age-adjusted normal range. It was reduced to 60 mg/4 weeks if mean GH , 1 mg/l and IGF-I was within the normal range. If the values did not fall within these ranges, the dose remained unchanged at 90 mg. Results: After 24 weeks of treatment with L-Autogel (final doses 60 mg in 3 patients, 90 mg in 4 patients and 120 mg in 18 patients), mean serum GH (2.9^2.4 mg/l) and IGF-I concentrations (332^193 mg/l) remained statistically unchanged when compared with baseline values under octreotide LAR (GH 2.4^1.8 mg/l and IGF-I 337^201 mg/l, non significant (NS)). There was a significant improvement of the acromegalic symptom score over the study period, from 4.8^3.4 to 2.8^2.5 (P , 0.001) and a small but significant reduction in the residual pituitary tumour volume (P , 0.05). Local side-effects were observed less frequently and no technical problems were encountered with the L-Autogel injections, as opposed to treatment with octreotide LAR (60 difficult injections/150 (P , 0.001)). Conclusions: L-Autogel appears to be as effective as octreotide LAR in lowering GH and IGF-I concentrations in acromegalic patients. This treatment was also well tolerated by the patients, giving fewer local side-effects and technical problems with injections. These advantages may improve the long-term acceptability of medical treatment in acromegaly.

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Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Alexopoulou¹,

Abrams

Verhelst

et al. 2004

European Journal of Endocrinology

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“…Octreotide can control GH and insulin-like growth factor (IGF-1) secretion, on average, in approximately two-thirds of patients with acromegaly and, when used as primary therapy, it can induce significant tumour shrinkage in approximately 30% of patients (4,5). Lanreotide, an alternative SA of comparable potency, is available as twice-weekly or monthly preparations (4,6,7).…”

Section: Introductionmentioning

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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“…a Frequencies are adopted from: octreotide LAR: http://www.rxlist.com according to manufacturer reports Cozzi et al, 2003;Davies et al, 1998;Flogstad et al, 1997;Jallad et al, 2005;Lancranjan and Atkinson, 1999;Lancranjan et al, 1996;Stewart et al, 1995); lanreotide autogel: Caron et al, 2002Caron et al, , 2006Lucas and Astorga, 2006); lanreotide SR: Attanasio et al, 2003;Caron et al, 1997;Chanson et al, 2000a,b;Giusti et al, 1996;Gutt et al, 2005;Lucas et al, 2003;Marek et al, 1994;Morange et al, 1994;Verhelst et al, 2000).…”

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confidence: 99%

Somatostatin agonists for treatment of acromegaly

Ben-Shlomo

Melmed

2008

Molecular and Cellular Endocrinology

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The discovery of somatotropin-release inhibitory factor (SRIF) in hypothalamic extract in 1970 led to the synthesis of the first somatostatin analog octreotide, discovery of five somatostatin receptor subtypes, and development of additional somatostatin receptor ligands (SRL) as pharmacotherapy for acromegaly and other neuroendocrine tumors. Long-acting formulations of SRL (octreotide LAR Depot, lanreotide SR and lanreotide autogel) assure improved patient compliance with weekly up to monthly injections, and are commonly used as primary or adjuvant treatment of acromegaly. We review SRL currently available, emphasizing long-acting compounds and their efficacy in controlling acromegaly. Disease control is evaluated by biochemical markers, tumor shrinkage, and diseasesymptom improvement balanced against drug-related side effects.

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Lanreotide 60 mg, a New Long-Acting Formulation: Effectiveness in the Chronic Treatment of Acromegaly

Cited by 71 publications

References 31 publications

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

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

Somatostatin agonists for treatment of acromegaly

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