A Multicenter Clinical Trial of SMS 201-995 (octreotide acetate) in Acromegaly and Gigantism

Abstract

Sixty-four patients with active acromegaly and three patients with gigantism were treated with the long acting somatostatin analog SMS 201-995 (50-500 micrograms, sc, every 6-12 h or 150-880 micrograms daily by intermittent sc infusion, for up to 114 weeks). The fasting plasma GH levels were significantly suppressed (less than 50% of the values before treatment) in 49 patients and became normal in 18 patients. Suppression of GH secretion was associated with normalization of plasma somatomedin-C levels (14 out of 30 cases) and significant clinical improvement such as disappearance of headache and decrease of excessive sweating. Shrinkage of pituitary tumors as determined by computed tomography and/or magnetic resonance imaging studies occurred in 11 out of 40 cases. Side effects were minimal and tolerable. SMS 201-995 appears to be an effective agent for the treatment of acromegaly and gigantism.

Effects of preoperative octreotide treatment on different subtypes of 90 GH-secreting pituitary adenomas and outcome in one surgical centre

“…It reduced tumour size only in 11% of the group, and rarely returned the plasma GH or IGF-I concentrations to the normal range, and tumour consistency was mostly soft. As shown by others (7,8,15), surgical results in grossly invasive adenomas could not be in¯uenced by octreotide pretreatment using normalization of plasma GH concentrations as the endpoint. Therefore, if this subtype of tumour is under-represented in the untreated group, overall results are not comparable.…”

Treatment of Thyrotropin-Secreting Pituitary Adenomas with Octreotide.

“…The suppressive effect of octreotide appears to be longer lasting in TSH-secreting pituitary adenomas [22], when compared to the suppression of GH (average; 6-8 h) in acromegaly [6,23]. From our experience, a regimen of twice daily (or even once daily) injection of octreotide might be sufficient to achieve suppression of TSH and thyroid hormones in most cases.…”

“…Medical treatment such as dopamine agonists has not usually been successful in controlling tumor growth and hormonal hypersecretion except in a few cases [3,4]. Long acting somatostatin (SRIF) analogs, which have proved effective in the management of acromegaly and pituitary gigantism [5,6], are potentially useful agents in patients with hyperthyroidism due to TSH-secreting pituitary adenoma [7,8]. Until now more than seventy cases treated with octreotide have been described in the literature [1].…”

Short-Term Effects of Octreotide on Glucose Tolerance in Patients with Acromegaly.

“…Recently, octreotide, a long-acting somatostatin analogue, has proved effective in the treatment of acromegaly [5]. The effects of octreotide on plasma levels of glucose and insulin in healthy subjects [6] and in patients with acromegaly [7][8][9][10][11] have been reported.…”