The somatostatin analogue SOM230, compared with octreotide, induces differential effects in several metabolic pathways in acromegalic patients

Summary Objective Recently, our first clinical study with the novel multiligand somatostatin (SRIF) analogue SOM230 in acromegalic patients showed that SOM230, due to its beneficial inhibitory effects on GH levels compared with octreotide (OCT), might increase the number of patients that can be biochemically controlled. Since SRIF analogues are also known to interact with other metabolic pathways, IGF‐I, IGFBP‐1, glucose and insulin concentrations on the control day (CD) and on treatment days following a single s.c. injection SOM230 100 and 250 µg, were compared to those following OCT 100 µg. Design and patients Randomized, cross‐over, double‐blinded proof‐of‐concept trial in 12 patients with active acromegaly. Results Free IGF‐I levels were suppressed after 24 h by OCT, SOM230 250 and 100 µg, whereas at 48 h only both SOM230 dosages still induced these inhibitory effects. Circulating IGFBP‐1 levels (AUC; 0830–1430 h) compared with CD, increased sharply after OCT (from 48 to 237 µg/l/h; P