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Long‐term (up to 18 years) effects on GH/IGF‐1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH‐secreting pituitary adenoma responsive to SSTa
Author(s) -
Maiza Jean Christophe,
Vezzosi Delphine,
Matta Maria,
Donadille Florence,
LoubesLacroix Florence,
Cournot Maxime,
Bennet Antoine,
Caron Philippe
Publication year - 2007
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2007.02878.x
Subject(s) - acromegaly , medicine , somatostatin , endocrinology , context (archaeology) , pituitary adenoma , adenoma , transsphenoidal surgery , prospective cohort study , gastroenterology , octreotide , hormone , biology , growth hormone , paleontology
Summary Context The role of somatostatin analogues (SSTa) in the treatment of acromegaly. Objective To evaluate the antihormonal and antitumour efficacy of long‐term (up to 18 years) primary treatment with SSTa in patients with GH‐secreting pituitary adenoma responsive to SSTa. Design An open, prospective, single‐centre, clinical study. Patients Thirty‐six acromegalic patients, aged 17–75 years (postoral glucose tolerance test GH > 1 µg/l, increased IGF‐1 for age and sex), were monitored in a single centre and treated with SSTa as first‐line therapy. The mean pretreatment GH level was 13·5 ± 3·1 µg/l, and IGF‐1 (as a percentage of the value over the normal range) was 302 ± 26%. The patients had macroadenoma ( n = 25), microadenoma ( n = 8) or empty sella turcica ( n = 3). The mean duration of treatment was 8 years (range 3–18 years). Hormonal and morphological monitoring was undertaken after 6 months, and then the patients were followed annually. Results After 1 year, the mean GH and IGF‐1 levels had reduced considerably (GH: 2·4 ± 0·3 µg/l; IGF‐1; 174 ± 14%, P < 0·01), and they continued to decrease over 10 years, with a mean GH level of 1·6 ± 0·1 µg/l and IGF‐1 of 123 ± 18% ( P = 0·02). GH < 2 µg/l, normal IGF‐1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively. The mean reduction in tumour volume was 43% (range 13–97%) and shrinkage > 20% was obtained in 21 patients (72%). SSTa treatment was well tolerated with few digestive or metabolic side‐effects. Conclusion Long‐term (up to 18 years) treatment with SSTa used as first‐line therapy is effective from both an antihormonal and antitumour perspective, and is well tolerated in acromegalic patients.