Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients

Seul young Kim; Dohee Kim

doi:10.3803/jkes.2010.25.1.37

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Kim and Kim: Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients

Original Article

J Korean Endocr Soc 2010;25(1):37-45.

Published online: 10 January 2010

DOI: https://doi.org/10.3803/jkes.2010.25.1.37

Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients

Seul young Kim, Dohee Kim¹

Department of Internal Medicine, Chungnam National University, College of Medicine

¹Department of Internal Medicine, Dankook University, College of Medicine

Received 2 February 2009 Accepted 25 September 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Somatostatin analogues have been used as the first-line medical therapy for active acromegaly that is not completely cured, or which recurs after surgery. The aim of this study was to compare the effects of octreotide long-acting repeatable (LAR) and lanreotide Autogel. Such a comparison has not been reported in Korea.

Methods

Twenty-seven patients who had previously undergone surgery for acromegaly from December 2003 to March 2005 were included. We retrospectively investigated eight patients who underwent operation only and 19 patients who additionally received medical treatment after surgery (octreotide LAR, n = 5; lanreotide Autogel, n = 5). Growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels were measured.

Results

The mean pre-operative and post-operative levels of GH were lower in patients who underwent surgery only than in those who received adjuvant therapy, but IGF-I levels were not significantly different. In the 19 patients receiving medical treatment after unsuccessful surgery, the mean baseline GH levels were 24.2 μg/L for octreotide LAR and 22.8 μg/L for lanreotide Autogel (P = 0.711), and the mean GH levels 36 months post-treatment were 4.1 μg/L and 2.5 μg/L, respectively (P = 0.794). GH < 2.5 μg/L represented 30% of octreotide LAR patients and 33.3% of lanreotide Autogel patients (P = 0.91). Patients with normal IGF-I levels represented 54.5% and 66.7%, respectively (P = 0.71).

Conclusion

No significant difference in therapeutic effect of octreotide LAR and lanreotide Autogel was evident in 19 Korean acromegalic patients who were not completely cured by surgery and radiation therapy.

Keywords: Acromegaly, Lanreotide, Somatostatin LAR

References

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Fig. 1.

Mean GH and IGF-Ⅰ levels according to treatment modality during the medical treatment. A. GH levels, B. IGF-I levels.

Fig. 2.

Mean GH and IGF-I levels during the treatment with octreotide LAR or lanreotide Autogel. A. GH levels, B. IGF-I levels.

Table 1.

Baseline characteristics of the study population according to treatment modality

	Operation (n = 8)	Operation + medication (n = 9)	Operation + medication + radiation therapy (n = 10)	P
Age (yr)	44 (24∼55)	40.5 (25∼51)	45.6 (26∼66)	0.617*
Sex				0.11^†
M	6 (75%)	3 (33.3%)	3 (30%)
F	2 (25%)	6 (66.6%)	7 (70%)
GH (μg/L)	20.0 (1.2∼51.3)	41.1 (6.6∼99.8)	107.9 (12.8∼395.0)	0.037*
IGF-I (μg/L)	1,022 (551∼1,665)	1,951 (747∼5,617)	1,269 (345∼1,719)	0.099*
Tumor size (cm)
pre-operation	2.1 (1.4∼3.0)	1.5 (1.0∼2.4)	3.1 (1.5∼7.6)	0.007*
post-operation	0	0.8 (0∼2.0)	0.7 (0∼2.0)	0.42*
DM				0.60^†
Positive	4 (50%)	3 (37.5%)	3 (37.5%)
Negative	4 (50%)	5 (62.5%)	8 (72.7%)
Glucose (mg/dl)	124 (74∼218)	101 (86∼141)	116 (76∼175)	0.61*
C/T ratio	0.49 (0.4∼0.6)	0.41 (0.4∼0.5)	0.47 (0.4∼0.5)	0.49*

All data are presented as mean value (minimum value-maximum value). C/T ratio, cardio-thoracic ratio; GH, growth hormone; IGF-I, Insulin-like growth factor-I; IGFBP-3, Insulin-like growth factor-binding protein-3.

^* P-values were calculated by Kruskal-Wallis test.

^† P-values were calculated by Chi-square test.

Table 2.

Mean GH and IGF-I levels obtained 0, 6, 12, 24, 36 month during the medical treatment according to treatment modality

	Month	Operation (n = 8)	Operation + medication (n = 9)	Operation + medication + radiation therapy (n = 10)	P*
GH (μg/L)	0	1.6 (0.7∼3.1)	21.1 (2.7∼85.9)	25.9 (3.6∼74.2)	< 0.01
	6	1.8 (0.5∼3.1)	11.5 (1.0∼50.0)	18.8 (1.1∼69.0)	0.012
	12	1.5 (0.1∼3.2)	8.2 (1.0∼31.6)	8.3 (1.3∼28.9)	0.042
	24	1.3 (0.2∼2.2)	4.0 (0.7∼8.2)	5.7 (0.9∼13.9)	0.026
	36	1.1 (0.7∼1.7)	2.3 (0.4∼5.1)	4.9 (1.4∼12.1)	0.019
IGF-I (μg/L)	0	938 (264∼3,511)	1,474 (425∼4,679)	859 (230∼1,410)	0.334
	6	675 (228∼1,665)	762 (131∼1,840)	646 (254∼1,269)	0.868
	12	404 (171∼998)	518 (232∼760)	491 (177∼895)	0.431
	24	444 (179∼872)	507 (152∼940)	415 (224∼689)	0.869
	36	264 (168∼425)	571 (172∼1,292)	257 (130∼385)	0.145

All data are presented as mean value (minimum value-maximum value). GH, growth hormone; IGF-I, Insulin-like growth factor-I.

^* P-values were calculated by Kruskal-Wallis test.

Table 3.

Mean GH and IGF-I levels in obtained 0, 6, 12, 24, 36 month during the treatment with octreotide LAR and lanreotide Autogel

	Month	Ocreotide LAR (n = 14)	Lanreotide Autogel (n = 5)	Lanreotide Autogel (n = 5)	P
Age (yr)		43.5 (26∼66)	43.4 (25∼66)	43.5 (25∼66)	0.75*
Sex					0.22^†
M		4 (28.6%)	2 (40%)	6 (31.6%)
F		10 (71.4%)	3 (60%)	13 (68.4%)
Treatment					0.345^†
Op + Med		5 (35.7%)	3 (60%)	8 (42.1%)
Op + Med + RTx		9 (64.3%)	2 (40%)	11 (57.9%)
GH (μg/L)	0	24.2 (2.7∼85.9)	22.8 (4.8∼69.3)	23.9 (2.7∼85.9)	0.711*
	6	13.9 (1.0∼50.7)	21.3 (2.8∼69.0)	15.6 (1.0∼69.0)	0.832*
	12	10.1 (1.0∼31.6)	3.8 (2.4∼5.1)	8.2 (1.0∼31.6)	0.187*
	24	4.9 (0.7∼13.9)	4.9 (1.8∼6.7)	4.9 (0.7∼13.9)	0.794*
	36	4.1 (0.4∼12.1)	2.5 (1.7∼3.0)	3.7 (0.4∼12.1)	0.310*
IGF-I (μg/L)	0	1,240 (230∼4,679)	774 (270∼1,335)	1,118 (230∼4,679)	0.355*
	6	693 (254∼1,840)	710 (131∼1,269)	698 (131∼1,840)	0.832*
	12	534 (177∼895)	424 (232∼632)	502 (177∼895)	0.292*
	24	476 (224∼940)	400 (152∼655)	454 (152∼940)	0.671*
	36	392 (130∼1,292)	370 (291∼497)	387 (130∼1,292)	0.697*

All data are presented as mean value (minimum value-maximum value). LAR, long-acting repeatable; GH, growth hormone; IGF-I, Insulin-like growth factor-I. Op + Med: operation and medication. Op + Med + RTx: operation, medication, and radiation therapy.

^* P-values were calculated by Mann-Whitney test.

^† P-values were calculated by Chi-square test.

Table 4.

The effect of octreotide LAR and lanreotide Autogel on the normalization of GH and IGF-I levels

	Month	Octreotide LAR (n = 14)	Lanreotide Autogel (n = 5)	P*
GH ≤ 2.5 μg/L	0	0/14 (0%)	0/5 (0%)
	6	3/13 (21.4%)	0/4 (0%)	0.310
	12	3/12 (25%)	1/5 (20%)	0.825
	24	3/11 (27.3%)	1/4 (25%)	0.930
	36	3/10 (30%)	1/3 (33.3%)	0.913
IGF-I with normal range	0	0/14 (0%)	0/5 (0%)
	6	4/14 (28.6%)	1/4 (25%)	0.888
	12	5/12 (41.7%)	3/5 (60%)	0.490
	24	6/10 (60%)	2/4 (50%)	0.733
	36	6/11 (54.5%)	2/3 (66.7%)	0.707

All data are presented patient number/total patient number (%). LAR, long-acting repeatable; GH, growth hormone; IGF-I, Insulin-like growth factor-I.

^* P-values were calculated by Chi-square test.

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