Retrospective Evaluation of Acromegaly Patients Unresponsive to Treatment with Octreotide-LAR Subsequently Treated with Lanreotide Autogel
Presentation Number: SUN 462
Date of Presentation: April 2nd, 2017
Wesley Flavio Lima Jr., Armindo Jreige Jr., Andre Metzker Ferro, Vitoria Espindola Leite Borges, Arthur Disegna, Rhenan Reis and Luciana Ansaneli Naves*
University of Brasilia, Brasilia, Brazil
Acromegaly is a chronic and debilitating disease that results from sustained exposure to high levels of growth hormone (GH) and growth factor similar to insulin (IGF-1). The control of serum levels of these hormones changed significantly the morbidity of these patients, demonstrating the importance of adherence to treatment. Among the main therapies currently used to treat this disease are surgery, medical treatment and radiotherapy. The most used drugs to treat the disease are the somatostatin analogs including octreotide and lanreotide acting in the suppression of GH secretion, but there are no consensus on the best therapeutic regimen . Objectives: This study aims to evaluate the effectiveness of Somatuline Autogel as an alternative regimen to treat patients who have not reached normalization of IGF-1, on octreotide treatment. Methods: the patients recruitment was based on database revision which contains all patients with acromegaly in regular medical care at the University Hospital of Brasilia (HUB). The cohort consisted of two groups, as first line therapy in recently diagnosed patients and in in patients unresponsive to Octreotide-LAR, treated for at least one year and were switched to lanreotide regimen for at least six months. Results:The medical records of these patients was consulted on the IGF-I levels (routine monitoring for acromegaly used in this center), the history, and the extent of the tumor on MRI. IGF-I levels for each patient at diagnosis the disease, before an after treatment with lanreotide and after treatment were analysed. As effectiveness criteria adopted the behavior of IGF-1 and ULNV values of patients during treatment. Based on the data obtained it was observed that the lanreotide was effective in decreasing the analyzed índices.All except one patient have shown satisfactory results on IGF-1 levels. IGF-I values of these patients reduced from 382.56 ± 179.05% to 162.80 ± 104.10% after the introduction of lanreotide treatment (p = 0.043) both in patients without previous use of other somatostatin analogs as in patients unresponsive to Octreotide. Two patients had been in use of Octreotide LAR in doses of 30 mg every 28 days with limited to drug responsiveness, and showed significant improvement after replacement by lanreotide 120 mg (IGF-I values dropped from 128% to 101% and from 415.07% to 267.06% both treated for 3 months).Lanreotide, when used in the treatment of acromegalic patients previously non-controlled Otreotide LAR is effective to reduce the mean levels of IGF-I short-term. Despite the low number of patients followed in this cohort, our study suggests that lanreotide has capacity equivalent to Octreotide LAR in biochemical normalization of acromegaly and should be a therapeutic alternative for patients resistant to Octreotide LAR.
Nothing to Disclose: WFL Jr., AJ Jr., AMF, VELB, AD, RR, LAN