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Pituitary (2012) 15:398404 DOI 10.1007/s11102-011-0335-y
Comparison of octreotide LAR and lanreotide autogel as post-operative medical treatment in acromegaly
Yasemin Tutuncu Dilek Berker Serhat Isik
Ufuk Ozuguz Gulhan Akbaba Ferit Kerim Kucukler
Yusuf Aydin Serdar Guler
Published online: 24 August 2011 The Author(s) 2011. This article is published with open access at Springerlink.com
Abstract Long-acting somatostatin analogs are frequently used as adjuvant treatment of acromegaly patients after noncurative surgery. This sudy aims to compare the efcacy of octreotide long-acting release (OCT) and lanreotide Autogel (LAN) in acromegaly patients. Sixty-eight patients not cured by transsphenoidal endoscopic or microscopic pituitary surgery between 2003 and 2009 were retrospectively analyzed (25 men; 43 women; mean age41.1 10.9 years [range 1865 years]). The patients were assigned randomly to OCT (n = 36) and LAN (n = 32) groups. Evaluations included insulin-like growth factor I (IGF-I) and growth hormone (GH) after oral glucose tolerance test (OGTT) 3, 6, 12 and 18 months after starting medical treatment; pituitary magnetic resonance imaging was performed before treatment and after 3 and 12 months. Patients achieving IGF-I levels within the age and gender normal range and GH level\1 lg/l following OGTT were considered a biochemical cure. Mean IGF-I and GH values and tumor volumes (cm3) in the LAN and OCT groups were similar in the post-operative period before initiation of medical treatment. A statistically signicant decrease in GH and IGF-I levels was obtained for both treatment groups at each follow-up visit compared to the previous value. Tumor
shrinkage after 12 months of treatment was statistically signicant in both groups but the percentage tumor shrinkage (28.5% vs. 34.9%, P = 0.166) and rate of patients achieving biochemical cure (63.9 and 78.1%, P = 0.454) were similar between OCT and LAN groups, respectively. OCT and LAN treatment options have similar efcacy for ensuring biochemical cure and tumor shrinkage in acromegaly patients who had noncurative surgery.
Keywords Acromegaly Somatostatin analogs
Octreotide Lanreotide
Introduction
Acromegaly is a rare chronic disease. Primarily dependent upon a pituitary adenoma that excretes excessive amounts of growth hormone (GH), in very rare cases (\1%), it may depend on the increase in growth hormone-releasing hormone [1]. The increase in GH and insulin-like growth factor I (IGF-I) levels that causes clinical acromegaly is also responsible for the...