Therapeutic effect of presurgical treatment with longacting octreotide (Sandostatin® LAR®) in patients with acromegaly

Abstract

Introduction: The aim of this study was to assess the therapeutic effect and the safety of pre-surgical treatment with long-acting octreotide in patients with acromegaly. Material and methods: This project was conducted in 25 centres across Poland as a non-interventional, multicentre, observational study in patients with acromegaly, in which long-acting octreotide (Sandostatin ® LAR ®) was administered before surgery. They were 148 patients included into the study: 88 females and 60 males aged 18-86 years (51.3 ± 13.4). Results: Eighty patients completed the study (underwent tumour surgery). The CRF included: baseline visit, four follow-up visits every three months before surgery, and two follow-up visits every three months after surgery. Sandostatin ® LAR ® was administered every four weeks. The efficacy measures were as follows: change of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, number of patients fulfilling criteria of cure, and change of adenoma (micro-and macroadenomas) size during the treatment. Normalisation of GH and IGF-1 concentrations were obtained in 42.4 and 49.1% of patients at the end of medical therapy, respectively. Normalisation of GH and IGF-1 concentrations were obtained in 77.9 and 83.8% of patients after surgery, respectively. Reduction of microadenoma size was documented in 58.8% of patients, and in 70% of patients with macroadenomas at the end of medical therapy. In 74.0% of patients no pituitary tumour was shown on MRI after surgery. Conclusion: In conclusion, we have shown good surgical outcome in patients with acromegaly after pre-treatment with somatostatin analogue, and good tolerance and safety of the therapy, supporting the national recommendation for pre-surgical treatment with longacting somatostatin analogues in acromegaly patients.

Complications and Comorbidities of Acromegaly—Retrospective Study in Polish Center

“…In the population of our patients, we can observe substantial domination of females. Similar outcomes were reported in Polish multicenter study ( 17 ), as well as in other European registries ( 18 – 23 ). Not statistically significant, but also a higher ratio of incidence of macroadenomas to microadenomas in men compared to women was detected in the French population ( 21 ).…”

“…Ischemic heart disease was diagnosed in 7% of our patients. The incidence in previous registries was between 2.5 and 12% ( 17 , 19 , 28 ).…”

“…In our study hypertension was the dominant complication from the cardiovascular group – it occurred in 58% of patients, which is consistent with previous studies. It has been reported that it occurs approximately in one-third of patients, ranging from 18 to 60% ( 4 , 17 , 28 – 30 ). What is more, the prevalence that we obtained is higher than in the general Polish population, which is 42.7% ( 31 ).…”

“…The prevalence of diabetes in acromegaly patients is 12% to 53% ( 17 , 19 , 30 , 33 , 34 ). We observed diabetes in 33% of the cases and prediabetes in 34%, which is much higher than in the general Polish population (6.97%) ( 25 ).…”

“…There is a proven correlation between thyroid gland volume and GH and IGF-I levels ( 39 , 40 ). The prevalence of goiter in acromegaly patients reaches between 25 and 92% of the cases ( 17 , 19 , 39 , 41 , 42 ). We observed this complication in 52% of our patients.…”