Forty Month Follow-Up of Persistent and Difficultly Controlled Acromegalic Patients Treated with Depot Long Acting Somatostatin Analog Octreotide

The objective of the present study was to investigate the effcts of octreotide long acting release(S-LAR)preparation on GH and IGF-1 serum concentrations and pituitary tumor size in patients with persistent and difficultly controlled acromegaly even after adjuvant irradiation and/or doparnine agonists. Thirty-three patients with active acromegaly(26 female and 7 male, mean age;43.94±14.01 SD years)were included in this study. Patients were evaluated at baseline and at 6, 12, 30 and 40 months for GH, IGF-1, and GH response to OGTT and biliary ultrasonography. Sella MRI was performed at mitial and at 40 months. All patients received 20 mg S-LAR. Afterwards, the dosage was titrated to improve individual GH response and reduction of IGF-1 into normal ranges. Basal serum IGF-1 levels decreased from median:530 μg/l(IQR:420-600)to 340 μg/l(IQR:230-460)at 6 months(p =0.01), to 400 μg/l(IQR:222.4-600)at 12months(p=0.48), to 396 μg/l(IQR:318-468)at 30 months(p=0.49), to 482 μg/l(308-580)at 40months(P=0.47). Nadir GH levels in OGTT fell from 2.70 ng/ml(IQR:1.35-6.90)to 1.60 ng/ml(IQR:0.36-4.10)at 6 months(P=0.03), to 0.31ng/ml(IQR=0.18-0.65)at 12 months(P