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| Comparison of octreotide acetate LAR and lanreotide SR in patients with acromegaly |
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Objective: Efficacy of Sandostatin (SAS) LAR or lanreotide in pat. with acromegaly. Open, comparative, crossover, multicentre study.
Subjects: 125 pat., 58 men and 67 women aged between 18 and 76 years, mean age 47 years. 116 pat. completed the study. 3 dropouts due to side-effects during SAS LAR therapy (2 drug related).
Indications: acromegaly (125)
Dosage/Duration: 20 mg as i.m. injection at monthly intervals for 3 months(n=125), then 10 mg, 20 mg or 30 mg at monthly intervalsfor 3 months (n=98). Duration: 3 months (n=27), 6 months(n=98).
Comparisons: lanreotide 30 mg, twice per month (n=61) or 3 times per month (n=64) for 2 to 117 (mean 26) months.
Free Text: Tests: growth hormone (GH), insulin-like growth factor-1 (IGF-1), scores for signs and symptoms (headache, sweating, paraesthesia, fatigue, osteoarthralgia, carpal tunnel syndrome), blood pressure, heart rate, body weight, gallbladder ultrasound, body temperature. Pat. received lanreotide before the study. Group A (n=27) continued to receive lanreotide for 3 months, then switched to SAS LAR 20 mg/month for a further 3 months. Group B (n=98) switched to SAS LAR 20 mg/month on day 1 for 3 months, then dose was adjusted to 10 mg, 20 mg or 30 mg per month for a further 3 months. Symptom scores, body weight and prevalence of gallstones were not signif. affected by switch from lanreotide to SAS LAR. Pat. were studied at 26 centres in France, Spain and Germany. Very detailed report; see original for full data.
Results: GH decreased from mean 9.6 mU/ml at the end of lanreotide therapy to mean 6.8 mU/ml after 3 injections of SAS LAR (p<0.001). Proportions of pat. with GH <2.5 mcg/l and <1 mcg/l were 54% and 14%, resp. at the end of lanreotide therapy, increasing to 68% and 35%, resp. (p<0.001) after 3 months of SAS LAR therapy; proportion of pat. with normal IGF-1 levels increased from 48% to 65% at these times (p<0.001). Pat. with prior radiotherapy (n=59) had lower mean GH and IGF-1 levels, but effects of therapy were not signif. different between pat. with and without prior radiotherapy. Both drugs were generally well tolerated. In group B, increasing SAS LAR dose further lowered GH and IGF-1.
Side Effects: side-effects (24; gastrointestinal 15, acute pancreatitis 1, fever 1, urticaria at injection site 1, pain or swelling or erythema at injection site ?)
Author(s) Conclusion: Octreotide LAR 20 mg administered once monthly was more effective than lanreotide SR 30 mg administered 2 or 3 times monthly in reducing GH and IGF-I in patients with acromegaly.
Number of Cases: 125
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