EFFICACY OF SANDOSTATIN LAR AT A DOSE 10- 40 MG IN THE TREATMENT OF ACROMEGALY.

Based on data from the register of patients with acromegaly in Moscow Region, study have assessed the proportion of patients receiving treatment with somatostatin analogues (SA) as a primary or secondary treatment, as well as doses of medication, and treatment efficacy. At the beginning of 2011, there was information on 128 of the 140 registered patients with acromegaly. 79 (61,7 %) patients were treated with SA (Sandostatin LAR). Indications for drug therapy were following: 1) absence of clinical and hormonal remission after treatment - in 35 of 79 (44,3 %) patients (neurosurgical treatment - 20, radiation therapy - 6, combined neurosurgical and radiation therapy - 9 patients); 2) first-line therapy - 44 of 79 (55,7 %) patients. In 42 of 79 (53,1 %) patients with inadequate biochemical control against the background of use of Sandostatin LAR at a dose of 20 mg for 6-12 months, the dose was increased to 30 mg; further, in 31 (39,2 %) patients with unachieved target levels of growth hormone (GH) and insulin-like growth factor type-1 (IGF-1) against the background of therapy with a dose of 30 mg for 6-12 months, the dose was increased to 40 mg. The frequency and/or intensity of adverse events were not increased. Thus, 31/79 (39,2 %) patients with acromegaly have received Sandostatin LAR at a dose 40 mg, 11 (13,9 %) - at a dose 30 mg, 33 (41,8 %) - at a dose 20 mg, and 4 (5,1 %) patients received drug at a dose 10 mg. Complete remission of acromegaly (GH and IGF-1 target levels) was achieved in 19 of 33 (57,6 %), 6 of 11 (54,5 %) and 10 of 31 (32,2 %) patients treated with Sandostatin LAR in doses of 20, 30 and 40 mg, respectively. In addition, the achievement at least one target (GH or IGF-1) was observed in another 10 of 33 (30,3 %), 4 of 11 (3,2 %) and 9 of 31 (29 %) patients in these treatment groups. Increase of the dose of the SA to 30 and 40 mg allowed to achieve full control of GH and IGF-1 levels in other 6 and 10 patients, respectively. Overall, among all patients receiving drug treatment with SA at doses ranging from 10 to 40 mg, achievement at least one target was observed in 62 of 79 (78,5 %), and complete remission of acromegaly was documented in 39 of 79 (49,4 %) patients. Thus, drug therapy is an important part of treatment of patients with acromegaly. The use of high doses of Sandostatin LAR (30 or 40 mg) is safe and lead to increase of proportion of patients with acromegaly who have reached complete remission.

acromegaly, somatostatin analogues, Sandostatin LAR, growth hormone, insulin-like growth factor type-