EFFECACY AND SAFETY OF SANDOSTATIN® LAR IN HIGH DOSES: REVIEW OF RESEARCHES IN EUROPEAN CENTERS


Cite item

Full Text

Abstract

Therapy of somatostatin analogues plays an important role in the treatment of acromegaly and is used as an additional treatment after neurosurgical intervention or as a primary therapy. Prolonged form of octreotide (Swiss, Sandostatin® LAR) is the most studied and widely used as somatostatin analog. The initial dose of Sandostatin® LAR is typically 20 mg, however, according to many studies, it was noted that after the first 3 months of treatment does not always achieved remission of acromegaly and to better control the disease should increase the dose of the drug in most patients. This review focuses on the use of Sandostatin® LAR at high (30 mg per month or more) doses in patients with active acromegaly. The use of Sandostatin® LAR at high (30 mg per month or more) doses, increases the efficiency of achieving biochemical control of active acromegaly, without compromising the safety profile of this drug.

References

  1. Holdaway IM, Bolland MJ, Gamble GD. A meta-analysis of the effect of lowering serum levels of GH and IGF-I on mortality in acromegaly. Eur J Endocrinol 2008;159:89-95.
  2. Ludecke DK, Abe T. Transsphenoidal microsurgery for newly diagnosed acromegaly: a personal view after more than 1,000 operations. Neuroendocrinology 2006;83:230-39.
  3. Nomikos P, Buchfelder M, Fahlbusch R. The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical "cure". Eur J Endocrinol 2005;152:379-87.
  4. Melmed S, Casanueva F, Cavagnini F, et al. Consensus statement: medical management of acromegaly. Eur J Endocrinol 2005;153:737-40.
  5. Freda PU, Katznelson L, van der Lely AJ, et al. Long-acting somatostatin analog therapy of acromegaly: a meta-analysis. J Clin Endocrinol Metab 2005;90:4465-73.
  6. Ayuk J, Sheppard MC. Does acromegaly enhance mortality? Rev Endocr Metab Disord 2007;9:33-39.
  7. Ayuk J, Sheppard MC. Growth hormone and its disorders. Postgrad Med J 2006;82:24-30.
  8. Colao A, Ferone D, Marzullo P, et al. Long-term effects of depot long-acting somatostatin analog octreotide on hormone levels and tumor mass in acromegaly. J Clin Endocrinol Metab 2001;86:2779-86.
  9. Colao A, Pivonello R, Auriemma RS, et al. Beneficial effect of dose escalation of octreotide LAR as first-line therapy in patients with acromegaly. Eur J Endocrinol 2007;157:579-87.
  10. Lancranjan I, Bruns C, Grass P, et al. Sandostatin® LAR®: a promising therapeutic tool in the management of acromegalic patients. Metabolism 1996;45:67-71.
  11. Lancranjan I, Atkinson AB. Results of a European multicentre study with Sandostatin LAR in acromegalic patients. Sandostatin LAR Group. Pituitary 1999;1:105-14.
  12. Cozzi R, Attanasio R, Montini M, et al. Four-year treatment with octreotide-long-acting repeatable in 110 acromegalic patients: predictive value of short-term results? J Clin Endocrinol Metab 2003;88:3090-98.
  13. Cozzi R, Montini M, Attanasio R, et al. Primary treatment of acromegaly with octreotide LAR: a long-term (up to 9 years) prospective study of its efficacy in the control of disease activity and tumor shrinkage. J Clin Endocrinol Metab 2006;91:1397-403.
  14. Colao A, Pivonello R, Rosato F, et al. First-line octreotide-LAR therapy induces tumor shrinkage and controls hormone excess in patients with acromegaly: results from an open, prospective, multicentre trial. Clin Endocrinol (Oxf) 2006;64:342-51.
  15. Mercado M, Borges F, Bouterfa H, et al. A prospective, multicentre study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting repeatable octreotide) in the primary therapy of patients with acromegaly. Clin Endocrinol (Oxf) 2007;66:859-68.
  16. Yetkin DO, Boysan SN, Tiryakioglu O, et al. Forty-month follow up of persistent and difficultly controlled acromegalic patients treated with depot long acting somatostatin analog octreotide. Endocr J 2007;54:459-64.
  17. Colao A, Cappabianca P, Caron P, et al. Octreotide LAR vs. surgery in newly diagnosed patients with acromegaly: a randomized, open-label, multicentre study. Clin Endocrinol (Oxf) 2009;70:757-68.
  18. Gilbert J, Ketchen M, Kane P, et al. The treatment of de novo acromegalic patients with octreotide-LAR: efficacy, tolerability and cardiovascular effects. Pituitary 2003;6:11-18.
  19. Colao A, Pivonello R, Galderisi M, et al. Impact of treating acromegaly first with surgery or somatostatin analogs on cardiomyopathy. J Clin Endocrinol Metab 2008;93:2639-46.
  20. Colao A, Marzullo P, Cuocolo A, et al. Reversal of acromegalic cardiomyopathy in young but not in middle-aged patients after 12 months of treatment with the depot long-acting somatostatin analogue octreotide. Clin Endocrinol (Oxf) 2003;58:169-76.
  21. Cook D. Octreotide long-acting repeatable in acromegaly: achieving optimal control. Endocrinologist 2009;19:142-147.
  22. Giustina A, Bonadonna S, Bugari G, et al. High-dose intramuscular octreotide in patients with acromegaly inadequately controlled on conventional somatostatin analogue therapy: a randomised controlled trial. Eur J Endocrinol 2009;161:331-38.
  23. Feelders RA, Hofland LJ, van Aken MO, et al. Medical therapy of acromegaly: efficacy and safety of somatostatin analogues. Drugs 2009;69:2207-26.
  24. McKeage K, Cheer S, Wagstaff AJ. Octreotide long-acting release (LAR): a review of its use in the management of acromegaly. Drugs 2003;63:2473-99.
  25. Colao A, Auriemma RS, Galdiero M, et al. Impact of somatostatin analogs vs. surgery on glucose metabolism in acromegaly: Results of a 5 years observational, open, prospective study. J Clin Endocrinol Metab 2009;94:528-37.
  26. Melmed S, Colao A, Barkan A, et al. Guidelines for acromegaly management: an update. J Clin Endocrinol Metab 2009;94:1509-17.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2011 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies