Effectiveness of lanreotide autogel 120 mg at extended dosing intervals for acromegaly

Abstract

Purpose Recent data indicate that extended dosing intervals (EDIs) with lanreotide autogel 120 mg are effective and wellreceived among patients with acromegaly who have achieved biochemical control with monthly injections of long-acting somatostatin analogues (SSAs). We further evaluated the effectiveness of lanreotide autogel 120 mg delivered at EDIs (>4 weeks) in routine clinical practice. Methods Cross-sectional, multicentre, observational study conducted to determine the effectiveness-measured by control of serum insulin-like growth factor 1 (IGF-1)-of lanreotide autogel 120 mg at dosing intervals >4 weeks for ≥6 months in selected patients with acromegaly treated in routine clinical practice (NCT02807233). Secondary assessments included control of growth hormone (GH) levels, treatment adherence, patient satisfaction, and quality of life (QoL) using validated questionnaires (EQ-5D, AcroQoL, and TSQM-9). Patients who received radiotherapy within the last 6 months were excluded. Results Among 109 patients evaluated, mean (SD) age was 59.1 (13.2) years. IGF-1 values were normal (mean [SD]: 175.0 [74.5], 95% CI: 160.8-189.1) in 91.7% of cases and normal in 91.4% of patients without previous radiotherapy treatment (n = 81). GH levels were ≤2.5 and ≤1 ng/mL, respectively, in 80.6% and 58.3%. Most patients were treated either every 5-6 (57.8%) or 7-8 weeks (38.5%), with 2.8% treated greater than every 8 weeks. The mean AcroQoL score was 63.0 (20.1). The mean global treatment satisfaction score (TSQM-9) was 75.1 (16.6). Treatment adherence (defined as no missed injections) was 94.5%. Conclusion Lanreotide autogel 120 mg at intervals of >4 weeks provided IGF-1 control in more than 90% of patients with acromegaly. Treatment satisfaction and adherence were good. These findings support use of extended dosing intervals in patients who have achieved good biochemical control with long-acting SSAs.

Validation of Acromegaly Quality of Life Questionnaire (AcroQol) for the Iranian Population

“…The GoF indicators used for establishing the structural model demonstrated values of >0.75, demonstrating the substantial t of the model. Finally, the QoL in this population of patients with acromegaly was in line with the results of previous studies, showing that psychological status has a greater impact on QoL in this population (27).…”

Validation of Acromegaly Quality of Life Questionnaire (AcroQoL) for the Iranian population

“…The GoF indicators used for establishing the structural model demonstrated values of > 0.75, demonstrating the substantial fit of the model. Finally, the quality of life in this population of patients with acromegaly was in line with the results of previous studies, showing that psychological status has a greater impact on quality of life in this population [ 28 ]. Some study examined the quality of life and the associated factors in patients with acromegaly indicated quality of life is reduced in treated patients with acromegaly.…”

A systematic literature review to evaluate extended dosing intervals in the pharmacological management of acromegaly

“…Though not frequently reported, median time since diagnosis of acromegaly varied from 1.4 (interquartile range 0.9–3.5 years) to approximately 14 years (range 1.5–27.1 years) across studies in which patients were not newly diagnosed. The majority of studies reported that patients had previously received pharmacological treatment for acromegaly at standard or unreported intervals: SRLs (n = 22 [ 36 , 38 – 51 , 55 – 61 ]), pegvisomant monotherapy (n = 4 [ 36 , 38 , 48 , 51 ]), and pegvisomant combination therapy (n = 2 [ 37 , 51 ]). Median duration of previous treatment was not systematically reported, but studies often required that patients were receiving their previous treatment for ≥ 6 months to be eligible for study entry.…”

“…Control of IGF-I levels was reported at study end with LAN administered at EDIs in ≥ 70% of patients in all four studies in which some, all or an unreported proportion of patients had controlled IGF-I at baseline [ 49 , 51 , 55 , 57 ]. Additionally, control of IGF-I levels was achieved with LAN at EDIs by study end in 33%–65% of patients in studies where no patients had controlled IGF-I levels at baseline (n = 2/2 studies [ 52 , 53 ]).…”