Investigation into the Efficacy and Safety of Octreotide LAR in Japanese Patients with Acromegaly: Shizuoka Study
The efficacy and safety of the long-acting repeatable formulation of octreotide (OCT-LAR) treatment in patients suffering from acromegaly was investigated retrospectively in Shizuoka prefecture, Japan. Thirty patients (11 male, 19 female; average age, 48.9 years old), 29 of whom had undergone transs...
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Published in | Endocrine Journal Vol. 56; no. 9; pp. 1095 - 1101 |
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2009
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Abstract | The efficacy and safety of the long-acting repeatable formulation of octreotide (OCT-LAR) treatment in patients suffering from acromegaly was investigated retrospectively in Shizuoka prefecture, Japan. Thirty patients (11 male, 19 female; average age, 48.9 years old), 29 of whom had undergone transsphenoidal surgery previously, were treated with OCT-LAR. OCT-LAR was injected i.m. every 4 weeks with an intended protocol of 20 mg over 24 months, however, 46.7% of patients required the dose of OCT-LAR to be increased. The final average dose of OCT-LAR was 25.0 ± 6.8 mg. Administering OCT-LAR significantly decreased serum GH and insulin-like growth factor 1 (IGF-1) levels (from 13.7 ± 11.9 to 5.8 ± 7.3 μg/L and from 585 ± 263 to 339 ± 193.7 μg/L after 3 months, respectively). Among patients treated with OCT-LAR, 56.7% expressed ≤2.5 μg/L serum GH and 53.3% displayed serum IGF-1 levels within the normal range, while 36.7% met both criteria that indicated treatment success. A sufficient outcome was achieved in 73.3% of patients when the rate of GH ≤2.5 μg/L or normalization of IGF-1 was accumulated. OCT-LAR did not have a negative effect on glucose tolerance when hemoglobin A1c was used as a marker. A gallbladder polyp was found only in 1 patient but it was uncertain whether OCT-LAR was involved in its development because the patient was not examined before OCT-LAR treatment. There were no abnormalities on liver function tests in any patients. In conclusion, our results showed that OCT-LAR was safe and effective as a therapeutic option for Japanese patients with acromegaly in a postoperative setting, by controlling the disease activity. |
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AbstractList | The efficacy and safety of the long-acting repeatable formulation of octreotide (OCT-LAR) treatment in patients suffering from acromegaly was investigated retrospectively in Shizuoka prefecture, Japan. Thirty patients (11 male, 19 female; average age, 48.9 years old), 29 of whom had undergone transsphenoidal surgery previously, were treated with OCT-LAR. OCT-LAR was injected i.m. every 4 weeks with an intended protocol of 20 mg over 24 months, however, 46.7% of patients required the dose of OCT-LAR to be increased. The final average dose of OCT-LAR was 25.0 ± 6.8 mg. Administering OCT-LAR significantly decreased serum GH and insulin-like growth factor 1 (IGF-1) levels (from 13.7 ± 11.9 to 5.8 ± 7.3 μg/L and from 585 ± 263 to 339 ± 193.7 μg/L after 3 months, respectively). Among patients treated with OCT-LAR, 56.7% expressed ≤2.5 μg/L serum GH and 53.3% displayed serum IGF-1 levels within the normal range, while 36.7% met both criteria that indicated treatment success. A sufficient outcome was achieved in 73.3% of patients when the rate of GH ≤2.5 μg/L or normalization of IGF-1 was accumulated. OCT-LAR did not have a negative effect on glucose tolerance when hemoglobin A1c was used as a marker. A gallbladder polyp was found only in 1 patient but it was uncertain whether OCT-LAR was involved in its development because the patient was not examined before OCT-LAR treatment. There were no abnormalities on liver function tests in any patients. In conclusion, our results showed that OCT-LAR was safe and effective as a therapeutic option for Japanese patients with acromegaly in a postoperative setting, by controlling the disease activity. The efficacy and safety of the long-acting repeatable formulation of octreotide (OCT-LAR) treatment in patients suffering from acromegaly was investigated retrospectively in Shizuoka prefecture, Japan. Thirty patients (11 male, 19 female; average age, 48.9 years old), 29 of whom had undergone transsphenoidal surgery previously, were treated with OCT-LAR. OCT-LAR was injected i.m. every 4 weeks with an intended protocol of 20 mg over 24 months, however, 46.7% of patients required the dose of OCT-LAR to be increased. The final average dose of OCT-LAR was 25.0 +/- 6.8 mg. Administering OCT-LAR significantly decreased serum GH and insulin-like growth factor 1 (IGF-1) levels (from 13.7 +/- 11.9 to 5.8 +/- 7.3 microg/L and from 585 +/- 263 to 339 +/- 193.7 microg/L after 3 months, respectively). Among patients treated with OCT-LAR, 56.7% expressed <or=2.5 microg/L serum GH and 53.3% displayed serum IGF-1 levels within the normal range, while 36.7% met both criteria that indicated treatment success. A sufficient outcome was achieved in 73.3% of patients when the rate of GH <or=2.5 microg/L or normalization of IGF-1 was accumulated. OCT-LAR did not have a negative effect on glucose tolerance when hemoglobin A1c was used as a marker. A gallbladder polyp was found only in 1 patient but it was uncertain whether OCT-LAR was involved in its development because the patient was not examined before OCT-LAR treatment. There were no abnormalities on liver function tests in any patients. In conclusion, our results showed that OCT-LAR was safe and effective as a therapeutic option for Japanese patients with acromegaly in a postoperative setting, by controlling the disease activity. |
Author | TANAKA, Tokutaro NAKAMURA, Hirotoshi IWABUCHI, Masayasu INOUE, Tatsuhide IMURA, Mitsuo MATSUZAWA, Yuji IINO, Kazumi GENMA, Rieko OKI, Yutaka HATAYA, Yuji NISHIZAWA, Shigeru |
Author_xml | – sequence: 1 fullname: OKI, Yutaka organization: Second Division, Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan – sequence: 2 fullname: INOUE, Tatsuhide organization: Diabetes and Endocrinology Center, Shizuoka General Hospital, Shizuoka, Japan – sequence: 3 fullname: IMURA, Mitsuo organization: Department of Endocrinology and Metabolism, Yaizu City Hospital, Shizuoka, Japan – sequence: 4 fullname: TANAKA, Tokutaro organization: Department of Neurosurgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan – sequence: 5 fullname: GENMA, Rieko organization: Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan – sequence: 6 fullname: IWABUCHI, Masayasu organization: Department of Endocrinology and Metabolism, Seirei Mikatahara General Hospital, Hamamatsu, Japan – sequence: 7 fullname: HATAYA, Yuji organization: Department of Endocrinology and Metabolism, Shizuoka Hospital, Shizuoka, Japan – sequence: 8 fullname: MATSUZAWA, Yuji organization: Department of Neurosurgery, Seirei Numazu Hospital, Shizuoka, Japan – sequence: 9 fullname: IINO, Kazumi organization: Second Division, Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan – sequence: 10 fullname: NISHIZAWA, Shigeru organization: Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan – sequence: 11 fullname: NAKAMURA, Hirotoshi organization: Second Division, Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan |
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Cites_doi | 10.1507/endocrj.53.125 10.1046/j.1365-2265.1997.2491023.x 10.1007/s11154-007-9067-8 10.1159/000095535 10.1507/endocrj.42.739 10.1111/j.1365-2265.2007.02825.x 10.1210/jc.2007-2199 10.1507/endocrj.51.227 10.1517/17425255.4.6.783 10.1210/jc.2002-011841 10.1507/endocrj1954.33.743 10.1056/NEJM200004203421604 10.1056/NEJMra062453 10.3171/jns.1998.88.6.1002 10.1111/j.1365-2265.2008.03221.x 10.1210/jc.2006-1668 10.1210/jc.2007-1191 10.1210/jc.2008-1546 10.1210/jc.2003-031199 10.1530/EJE-07-0383 10.1186/1750-1172-3-17 |
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References | 20. Colao A, Auriemma RS, Galdiero M, Cappabianca P, Cavallo LM, Esposito F, Grasso LF, Lombardi G, Pivonello R (2009) Impact of somatostatin analogs versus surgery on glucose metabolism in acromegaly: results of a 5-year observational, open, prospective study. J Clin Endocrinol Metab 94: 528-537. 13. Landolt AM, Haller D, Lomax N, Scheib S, Schubiger O, Siegfried J, Wellis G (1998) Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy. J Neurosurg 88:1002-1008. 19. Park C, Yang I, Woo J, Kim S, Kim J, Kim Y, Sohn S, Kim E, Lee M, Park H, Jung J, Park S (2004) Somatostatin (SRIF) receptor subtype 2 and 5 gene expression in growth hormone-secreting pituitary adenomas: the relationship with endogenous srif activity and response to octreotide. Endocr J 51: 227-236. 5. Shimatsu A, Chihara K, Hizuka N, Teramoto A, Tanaka T, Tatsumi K, Tachibana K, Katsumata N, Yokoya S, Fujieda K (2007) Reference intervals of serum insulin-like growth factor-I in adult Japanese population: calculated with LMS methods. Horumon To Rinsho (Clinical endocrinology) 55: 393-399 (in Japanese). 11. Jackson SN, Fowler J, Howlett TA (1997) Cabergoline treatment of acromegaly: a preliminary dose finding study. Clin Endocrinol (Oxf) 46: 745-749. 21. Tolis G, Angelopoulos NG, Katounda E, Rombopoulos G, Kaltzidou V, Kaltsas D, Protonotariou A, Lytras A (2006) Medical treatment of acromegaly: comorbidities and their reversibility by somatostatin analogs. Neuroendocrinology 83: 249-257. 12. Trainer PJ, Drake WM, Katznelson L, Freda PU, Herman-Bonert V, van der Lely AJ, Dimaraki EV, Stewart PM, Friend KE, Vance ML, Besser GM, Scarlett JA, Thorner MO, Parkinson C, Klibanski A, Powell JS, Barkan AL, Sheppard MC, Malsonado M, Rose DR, Clemmons DR, Johannsson G, Bengtsson BA, Stavrou S, Kleinberg DL, Cook DM, Phillips LS, Bidlingmaier M, Strasburger CJ, Hackett S, Zib K, Bennett WF, Davis RJ (2000) Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. N Engl J Med 342: 1171-1177. 7. Schneider HJ, Sievers C, Saller B, Wittchen HU, Stalla GK (2008) High prevalence of biochemical acromegaly in primary care patients with elevated IGF-1 levels. Clin Endocrinol (Oxf) 69: 432-435. 8. Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A (2006) High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab 91: 4769-4775. 16. Ayuk J, Sheppard MC (2008) Does acromegaly enhance mortality? Rev Endocr Metab Disord 9: 33-39. 3. Murray RD, Melmed S (2008) A critical analysis of clinically available somatostatin analog formulations for therapy of acromegaly. J Clin Endocrinol Metab 93: 2957-2968. 17. Mercado M, Borges F, Bouterfa H, Chang TC, Chervin A, Farrall AJ, Patocs A, Petersenn S, Podoba J, Safari M, Wardlaw J (2007) 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) 66: 859-868. 22. Horikawa R, Takano K, Hizuka N, Asakawa K, Shibasaki T, Masuda A, Shizume K (1986) Effect of a single administration of somatostatin analogue (SMS 201-995) on GH, TSH and insulin secretion in patients with acromegaly. Endocrinol Jpn 33: 743-749. 2. Holdaway IM, Rajasoorya RC, Gamble GD (2004) Factors influencing mortality in acromegaly. J Clin Endocrinol Metab 89: 667-674. 15. Colao A, Pivonello R, Auriemma RS, Galdiero M, Savastano S, Lombardi G (2007) Beneficial effect of dose escalation of octreotide-LAR as first-line therapy in patients with acromegaly. Eur J Endocrinol 157: 579-587. 4. Vallette S, Serri O (2008) Octreotide LAR for the treatment of acromegaly. Expert Opin Drug Metab Toxicol 4: 783-793. 10. Melmed S, Casanueva FF, Cavagnini F, Chanson P, Frohman L, Grossman A, Ho K, Kleinberg D, Lamberts S, Laws E, Lombardi G, Vance ML, Werder KV, Wass J, Giustina A (2002) Guidelines for acromegaly management. J Clin Endocrinol Metab 87: 4054-4058. 6. Chanson P, Salenave S (2008) Acromegaly. Orphanet J Rare Dis 3: 17. 23. Sato K, Takamatsu K, Hashimoto K (1995) Short-term effects of octreotide on glucose tolerance in patients with acromegaly. Endocr J 42: 739-745. 1. Melmed S (2006) Medical progress: Acromegaly. N Engl J Med 355: 2558-2573. 18. Colao A, Marek J, Goth MI, Caron P, Kuhn JM, Minuto FM, Weissman NJ (2008) No greater incidence or worsening of cardiac valve regurgitation with somatostatin analog treatment of acromegaly. J Clin Endocrinol Metab 93: 2243-2248. 9. Dekkers OM, Biermasz NR, Pereira AM, Romijn JA, Vandenbroucke JP (2008) Mortality in acromegaly: a metaanalysis. J Clin Endocrinol Metab 93: 61-67. 14. Oshino S, Saitoh Y, Kasayama S, Arita N, Ohnishi T, Kohara H, Izumoto S, Yoshimine T (2006) Short-term preoperative octreotide treatment of GH-secreting pituitary adenoma: predictors of tumor shrinkage. Endocr J 53: 125-132. 11 12 23 13 HORIKAWA R (22) 1986; 33 14 15 16 17 18 19 1 2 3 4 5 6 7 8 9 20 10 21 |
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SubjectTerms | Acromegaly Acromegaly - drug therapy Acromegaly - etiology Adult Aged Delayed-Action Preparations - administration & dosage Delayed-Action Preparations - adverse effects Delayed-Action Preparations - therapeutic use Drug Administration Schedule Drug Monitoring Female Gigantism - drug therapy Growth Hormone-Secreting Pituitary Adenoma - complications Growth Hormone-Secreting Pituitary Adenoma - surgery Hormone Antagonists - administration & dosage Hormone Antagonists - adverse effects Hormone Antagonists - therapeutic use Human Growth Hormone - antagonists & inhibitors Human Growth Hormone - blood Humans Insulin-like growth factor 1 Insulin-Like Growth Factor I - analysis Japan Male Middle Aged Octreotide Octreotide - administration & dosage Octreotide - adverse effects Octreotide - therapeutic use Pituitary Neoplasms - complications Pituitary Neoplasms - surgery Retrospective Studies Time Factors Treatment Outcome Young Adult |
Title | Investigation into the Efficacy and Safety of Octreotide LAR in Japanese Patients with Acromegaly: Shizuoka Study |
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