Therapeutic options in the management of acromegaly: focus on lanreotide Autogel®

Abstract

BackgroundIn acromegaly, expert surgery is curative in only about 60% of patients. Postoperative radiation therapy is associated with a high incidence of hypopituitarism and its effect on growth hormone (GH) production is slow, so that adjuvant medical treatment becomes of importance in the management of many patients.ObjectiveTo delineate the role of lanreotide in the treatment of acromegaly.MethodsSearch of Medline, Embase, and Web of Science databases for clinical studies of lanreotide in acromegaly.ResultsTreatment with lanreotide slow release and lanreotide Autogel® normalized GH and insulin-like growth factor-I (IGF-I) concentrations in about 50% of patients. The efficacy of 120 mg lanreotide Autogel® on GH and IGF-I levels was comparable with that of 20 mg octreotide LAR. There were no differences in improvement of cardiac function, decrease in pancreatic β-cell function, or occurrence of side effects, including cholelithiasis, between octreotide LAR and lanreotide Autogel®. When postoperative treatment with somatostatin analogs does not result in normalization of serum IGF-I and GH levels after noncurative surgery, pegvisomant alone or in combination with somatostatin analogs can control these levels in a substantial number of patients.

<p>Octreotide-Resistant Acromegaly: Challenges and Solutions</p>

“…Indeed, some authors reported safe GH levels in 48-64% of patients and normal IGF-1 levels in 47-61%, while others showed a higher percentage of biochemical control (38-80% for GH and 39-80% for IGF-1). [30][31][32][33] Concerning the effect on tumor mass, a significant shrinkage (>20-25% volume reduction) was observed in about 63% of patients treated with LAN Autogel and 66% of those treated with OCT LAR. 34,35 Therefore, the efficacy of OCT LAR and LAN Autogel is considered superimposable.…”

Acromegaly — A Case Report with Dentist's Perspectives and Review of Literature

“…The disease is related to the excessive production of growth hormone after the fusion of epiphyseal plate. [5] Acromegaly is a rare disease, with a prevalence of 40 to 70 cases per million inhabitants and an annual incidence of 3 to 4 new cases per million inhabitants without geographical or sex differences. [5,6] However, a recent study performed in Belgium suggests it to be around 100-130 cases per million inhabitants.…”

“…[5] Acromegaly is a rare disease, with a prevalence of 40 to 70 cases per million inhabitants and an annual incidence of 3 to 4 new cases per million inhabitants without geographical or sex differences. [5,6] However, a recent study performed in Belgium suggests it to be around 100-130 cases per million inhabitants. Owing to its insidious onset, acromegaly is often diagnosed late (4 to more than 10 years after onset, average -40 years) as seen in our case.…”

“…[5,11] Local tumoral symptoms include chronic headache, visual field defects, and rarely cranial nerve palsies. [5,12] Other clinical features include arthritis, osteopenia, vertebral fractures, carpal tunnel syndrome, Cardiomyopathy, arrhythmias, valvulopathy, heart failure, Insulin resistance, diabetes, Hypogonadism and visceromegaly (Tongue, thyroid, salivary gland, liver, spleen, kidney, prostate) were not present in our case except for excessive perspiration and hypertension. [3,13,14] Bleuler was the first to study psychiatric symptoms in acromegaly.…”

Progress in the Formulation and Delivery of Somatostatin Analogs for Acromegaly

“…GH < 2.5 µg/l and a normalized IGF-1), demonstrating that both formulations have equal efficacy [22,28,38]. Nevertheless, Somatuline ® autogel ® is typically preferred by patients over Sandostatin ® LAR owing to its more convenient regime of administration: it is self-or care-giver injected and, unlike Sandostatin ® LAR, does not require a medically-qualified person for administration [39].…”