open access

Vol 71, No 4 (2020)
Original paper
Published online: 2020-08-06
Submitted: 2020-05-09
Accepted: 2020-05-12
Get Citation

Therapeutic effect of presurgical treatment with longacting octreotide (Sandostatin® LAR®) in patients with acromegaly

Marek Bolanowski, Wojciech Zgliczyński, Jerzy Sowiński, Agata Bałdys-Waligórska, Grażyna Bednarek-Tupikowska, Przemysław Witek, Grzegorz Zieliński, Włodzimierz Liebert, Lucyna Siemińska, Elżbieta Andrysiak-Mamos, Bogdan Marek, Dariusz Kajdaniuk, Joanna Malicka, Violetta Rosiek, Aleksandra Jawiarczyk-Przybyłowska, CSMS995BPL03 Investigators
DOI: 10.5603/EP.a2020.0050
·
Pubmed: 32901908
·
Endokrynologia Polska 2020;71(4):285-291.

open access

Vol 71, No 4 (2020)
Original Paper
Published online: 2020-08-06
Submitted: 2020-05-09
Accepted: 2020-05-12

Abstract

Introduction: The aim of this study was to assess the therapeutic effect and the safety of pre-surgical treatment with long-acting octreotide in patients with acromegaly. Material and methods: This project was conducted in 25 centres across Poland as a non-interventional, multicentre, observational study in patients with acromegaly, in which long-acting octreotide Sandostatin® LAR®) was administered before surgery. They were 148 patients included into the study: 88 females and 60 males aged 18–86 years (51.3 ± 13.4). Results: Eighty patients completed the study (underwent tumour surgery). The CRF included: baseline visit, four follow-up visits every three months before surgery, and two follow-up visits every three months after surgery. Sandostatin® LAR® was administered every four weeks. The efficacy measures were as follows: change of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, number of patients fulfilling criteria of cure, and change of adenoma (micro- and macroadenomas) size during the treatment. Normalisation of GH and IGF-1 concentrations were obtained in 42.4 and 49.1% of patients at the end of medical therapy, respectively. Normalisation of GH and IGF-1 concentrations were obtained in 77.9 and 83.8% of patients after surgery, respectively. Reduction of microadenoma size was documented in 58.8% of patients, and in 70% of patients with macroadenomas at the end of medical therapy. In 74.0% of patients no pituitary tumour was shown on MRI after surgery. Conclusion: We have shown good surgical outcome in patients with acromegaly after pre-treatment with somatostatin analogue, and good tolerance and safety of the therapy, supporting the national recommendation for pre-surgical treatment with long-acting somatostatin analogues in acromegaly patients.

Abstract

Introduction: The aim of this study was to assess the therapeutic effect and the safety of pre-surgical treatment with long-acting octreotide in patients with acromegaly. Material and methods: This project was conducted in 25 centres across Poland as a non-interventional, multicentre, observational study in patients with acromegaly, in which long-acting octreotide Sandostatin® LAR®) was administered before surgery. They were 148 patients included into the study: 88 females and 60 males aged 18–86 years (51.3 ± 13.4). Results: Eighty patients completed the study (underwent tumour surgery). The CRF included: baseline visit, four follow-up visits every three months before surgery, and two follow-up visits every three months after surgery. Sandostatin® LAR® was administered every four weeks. The efficacy measures were as follows: change of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, number of patients fulfilling criteria of cure, and change of adenoma (micro- and macroadenomas) size during the treatment. Normalisation of GH and IGF-1 concentrations were obtained in 42.4 and 49.1% of patients at the end of medical therapy, respectively. Normalisation of GH and IGF-1 concentrations were obtained in 77.9 and 83.8% of patients after surgery, respectively. Reduction of microadenoma size was documented in 58.8% of patients, and in 70% of patients with macroadenomas at the end of medical therapy. In 74.0% of patients no pituitary tumour was shown on MRI after surgery. Conclusion: We have shown good surgical outcome in patients with acromegaly after pre-treatment with somatostatin analogue, and good tolerance and safety of the therapy, supporting the national recommendation for pre-surgical treatment with long-acting somatostatin analogues in acromegaly patients.

Get Citation

Keywords

acromegaly; presurgical pharmacotherapy; neurosurgery

About this article
Title

Therapeutic effect of presurgical treatment with longacting octreotide (Sandostatin® LAR®) in patients with acromegaly

Journal

Endokrynologia Polska

Issue

Vol 71, No 4 (2020)

Article type

Original paper

Pages

285-291

Published online

2020-08-06

DOI

10.5603/EP.a2020.0050

Pubmed

32901908

Bibliographic record

Endokrynologia Polska 2020;71(4):285-291.

Keywords

acromegaly
presurgical pharmacotherapy
neurosurgery

Authors

Marek Bolanowski
Wojciech Zgliczyński
Jerzy Sowiński
Agata Bałdys-Waligórska
Grażyna Bednarek-Tupikowska
Przemysław Witek
Grzegorz Zieliński
Włodzimierz Liebert
Lucyna Siemińska
Elżbieta Andrysiak-Mamos
Bogdan Marek
Dariusz Kajdaniuk
Joanna Malicka
Violetta Rosiek
Aleksandra Jawiarczyk-Przybyłowska
CSMS995BPL03 Investigators

References (27)
  1. Melmed S. Medical progress: Acromegaly. N Engl J Med. 2006; 355(24): 2558–2573.
  2. Bolfi F, Neves AF, Boguszewski CL, et al. Mortality in acromegaly decreased in the last decade: a systematic review and meta-analysis. Eur J Endocrinol. 2018; 179(1): 59–71.
  3. Katznelson L, Laws ER, Melmed S, et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014; 99(11): 3933–3951.
  4. Melmed S, Bronstein MD, Chanson P, et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018; 14(9): 552–561.
  5. Bolanowski M, Ruchała M, Zgliczyński W, et al. Diagnostics and treatment of acromegaly - updated recommendations of the Polish Society of Endocrinology. Endokrynol Pol. 2019; 70(1): 2–18.
  6. Carmichael JD, Bonert VS, Nuño M, et al. Acromegaly clinical trial methodology impact on reported biochemical efficacy rates of somatostatin receptor ligand treatments: a meta-analysis. J Clin Endocrinol Metab. 2014; 99(5): 1825–1833.
  7. Colao A, Ferone D, Cappabianca P, et al. Effect of octreotide pretreatment on surgical outcome in acromegaly. J Clin Endocrinol Metab. 1997; 82(10): 3308–3314.
  8. Oshino S, Saitoh Y, Kasayama S, et al. Short-term preoperative octreotide treatment of GH-secreting pituitary adenoma: predictors of tumor shrinkage. Endocr J. 2006; 53(1): 125–132.
  9. Carlsen SM, Lund-Johansen M, Schreiner T, et al. Preoperative Octreotide Treatment of Acromegaly study group. Preoperative octreotide treatment in newly diagnosed acromegalic patients with macroadenomas increases cure short-term postoperative rates: a prospective, randomized trial. J Clin Endocrinol Metab. 2008; 93(8): 2984–2990.
  10. Biermasz NR, van Dulken H, Roelfsema F. Direct postoperative and follow-up results of transsphenoidal surgery in 19 acromegalic patients pretreated with octreotide compared to those in untreated matched controls. J Clin Endocrinol Metab. 1999; 84(10): 3551–3555.
  11. Plöckinger U, Quabbe HJ. Presurgical octreotide treatment in acromegaly: no improvement of final growth hormone (GH) concentration and pituitary function. A long-term case-control study. Acta Neurochir (Wien). 2005; 147(5): 485–93; discussion 493.
  12. Losa M, Mortini P, Urbaz L, et al. Presurgical treatment with somatostatin analogs in patients with acromegaly: effects on the remission and complication rates. J Neurosurg. 2006; 104(6): 899–906.
  13. Nunes VS, Correa JMS, Puga MES, et al. Preoperative somatostatin analogues versus direct transsphenoidal surgery for newly-diagnosed acromegaly patients: a systematic review and meta-analysis using the GRADE system. Pituitary. 2015; 18(4): 500–508.
  14. Yang C, Li Ge, Jiang S, et al. Preoperative Somatostatin Analogues in Patients with Newly-diagnosed Acromegaly: A Systematic Review and Meta-analysis of Comparative Studies. Sci Rep. 2019; 9(1): 14070.
  15. Pita-Gutierrez F, Pertega-Diaz S, Pita-Fernandez S, et al. Place of preoperative treatment of acromegaly with somatostatin analog on surgical outcome: a systematic review and meta-analysis. PLoS One. 2013; 8(4): e61523.
  16. Zhang L, Wu X, Yan Y, et al. Preoperative somatostatin analogs treatment in acromegalic patients with macroadenomas. A meta-analysis. Brain Dev. 2015; 37(2): 181–190.
  17. Bolanowski M, Bar-Andziak E, Kos-Kudła B, et al. [Konsensus Polskiego Towarzystwa Endokrynologicznego. Przygotowanie analogami somatostatyny do leczenia operacyjnego akromegalii]. Endokrynol Pol. 2007; 58(4): 350–353.
  18. Petrossians P, Daly AF, Natchev E, et al. Acromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) Database. Endocr Relat Cancer. 2017; 24(10): 505–518.
  19. Melmed S, Casanueva FF, Klibanski A, et al. Pituitary Society and the European Neuroendocrine Association. Diagnosis and treatment of acromegaly complications. J Endocrinol Invest. 2003; 26(12): 1242–1247.
  20. Cozzi R, Montini M, Attanasio R, et al. Primary treatment of acromegaly with octreotide LAR: a long-term (up to nine years) prospective study of its efficacy in the control of disease activity and tumor shrinkage. J Clin Endocrinol Metab. 2006; 91(4): 1397–1403.
  21. Caron PJ, Bevan JS, Petersenn S, et al. PRIMARYS Investigators. Tumor shrinkage with lanreotide Autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial. J Clin Endocrinol Metab. 2014; 99(4): 1282–1290.
  22. Mao Zg, Zhu Yh, Tang Hl, et al. Preoperative lanreotide treatment in acromegalic patients with macroadenomas increases short-term postoperative cure rates: a prospective, randomised trial. Eur J Endocrinol. 2010; 162(4): 661–666.
  23. Shen M, Shou X, Wang Y, et al. Effect of presurgical long-acting octreotide treatment in acromegaly patients with invasive pituitary macroadenomas: a prospective randomized study. Endocr J. 2010; 57(12): 1035–1044.
  24. Duan L, Zhu H, Xing B, et al. Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1-3): a retrospective cohort study conducted at a single center. BMC Endocr Disord. 2017; 17(1): 55.
  25. Lv L, Hu Yu, Zhou P, et al. Presurgical treatment with somatostatin analogues in growth hormone-secreting pituitary adenomas: A long-term single-center experience. Clin Neurol Neurosurg. 2018; 167: 24–30.
  26. Albarel F, Castinetti F, Morange I, et al. Pre-surgical medical treatment, a major prognostic factor for long-term remission in acromegaly. Pituitary. 2018; 21(6): 615–623.
  27. Polat Korkmaz O, Gurcan M, Nuhoglu Kantarci FE, et al. The effects of pre-operative somatostatin analogue therapy on treatment cost and remission in acromegaly. Pituitary. 2019; 22(4): 387–396.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl