The effectiveness of analysis of octreotide-depo, a long-acting somatostatin analog, for the treatment of the patients presenting with active phase of acromegalia

Abstract

This paper reports the results of the year-long treatment of 46 patients presenting with active phase of acromegalia (39 (85%) women and 7 (15%) men, at the age varying from 22 to 76 years) using the long-acting somatostatin analog octreotide-depo. The treatment was started using a dose of 20 mg with the measurement of GH and IGF-1 levels each 3 months; the dose was titrated as appropriate. The maximum dose of octreotide-depo amounted to 40 mg. The effectiveness of therapy was evaluated from the severity and frequency of the principle symptoms of acromegalia, viz. facial, hand, and leg soft tissue oedema, fatigue, excessive sweating, headache, arthralgia, elevated blood GH and IGF-1 levels. The target GH levels were considered to be below 2.5 ng/ml and those of IGF-1 within the normal age-specific concentration range. The most well-apparent regression of clinical symptoms was observed within the first 3 months after the onset of the treatment, concurrently with the maximum reduction of blood GH and IGF-1 levels. The values reached during the first 3 months remained unaltered up to the end of the study. Simultaneous normalization of the blood GH and IGF-1 levels was documented in 55% of the patients. The clinical symptoms most frequently disappeared in the patients with normal IGF-1 levels. The adverse reactions of octreotide-depo therapy included short-term diarrhea (45.6%), meteorism (25.1%), abdominal pain (26%), nausea (13.4%), constipation (10.8%). These conditions were not serious and did not require the withdrawal of the preparation.