Effects of Lanreotide Autogel on Growth Hormone,Insulinlike Growth Factor 1, and Tumor Size in Acromegaly: a 1-Year Prospective Multicenter Study

Attanasio, Roberto; Lanzi, Roberto; Losa, Marco; Valentini, Ferdinando; Grimaldi, Franco; Menis, Ernesto De; Davì, Maria Vittoria; Battista, Claudia; Castello, R.; Cremonini, Nadia; Razzore, Paola; Rosato, F.; Montini, M; Cozzi, Renato

doi:10.4158/ep.14.7.846

Cited by 38 publications

(18 citation statements)

References 34 publications

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“…Colao et al [38] reported tumor shrinkage in about 77% of newly diagnosed patients with acromegaly treated with lanreotide Autogel. Finally, Attanasio et al [37] reported that tumor shrinkage was relevant both in patients in whom lanreotide Autogel was prescribed as first-line treatment and in those previously treated by neurosurgery (71 vs. 80%).…”

Section: Resultsmentioning

confidence: 96%

Effects of lanreotide SR and Autogel on tumor mass in patients with acromegaly: a systematic review

Mazziotti,

Giustina

2009

Pituitary

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Long-acting somatostatin analogs (SSA) are widely used for the treatment of acromegaly achieving biochemical control of the disease in 50-75% of the patients. One of the goals of the treatment of acromegaly is the control of tumor growth, especially in patients in whom SSAs are used as first-line therapy. Over the recent years, there has been growing evidence that SSAs are able to induce tumor shrinkage in patients with acromegaly. However, most of the data are from patients under treatment with octreotide, either subcutaneously or intramuscularly with long-acting formulation, whereas the data on lanreotide SR or Autogel are very few. Indeed, octreotide and lanreotide, i.e. the two commercially available SSAs, show slight differences in pharmacokinetics and patterns of receptor affinities with potentially different therapeutic effects. We aimed to perform a systematic review of literature data concerning the shrinkage effects of long-acting lanreotide in patients with acromegaly. The analysis was focused on the following issues: differences in shrinkage effects between primary and secondary medical treatment, predictive value of baseline tumor volume and correlation between biochemical control and shrinkage effects. The peer-reviewed medical literature was searched to identify clinical trials studying the effects of lanreotide SR or Autogel on adenoma size in acromegaly. To be included in this analysis, studies had one of the following designs: randomized controlled trial; prospective, nonrandomized trial; retrospective study. Twenty-two studies were found to be eligible for the final analysis, in which tumor size was measured as an end-point for lanreotide treatment. Overall a total of 32.8% of patients experienced a variable degree (from 10 to 77%) of tumor shrinkage during lanreotide SR or Autogel treatment. The analysis showed that tumor shrinkage was more frequent in naïve patients as compared with those previously treated by radiotherapy, surgery or drugs other than lanreotide. The data on the correlation between tumor shrinkage and baseline tumor size were discordant, but when baseline tumor size was specified, more than 80% of patients undergoing shrinkage under lanreotide Autogel had macroadenomas. Finally, with lanreotide Autogel there was no evident correlation between biochemical response and tumor shrinkage. Our systematic review of the literature shows that lanreotide particularly when used as first-line therapy is able to quite frequently induce tumor shrinkage in patients with acromegaly. This finding suggests that this drug may have a role in the primary treatment of acromegaly.

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Section: Resultsmentioning

confidence: 96%

Effects of lanreotide SR and Autogel on tumor mass in patients with acromegaly: a systematic review

Mazziotti,

Giustina

2009

Pituitary

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“…This strategy capitalizes on the complementary modes of action of the two drug classes and mitigates concerns about tumor growth by incorporating SSAs, agents that can induce pituitary tumor shrinkage (14)(15)(16). Weekly, rather than daily, pegvisomant dosing offers the advantage of reduced injection frequency, which patients may prefer, even in the absence of further reduction in IGF1 levels (6, 17).…”

Section: Introductionmentioning

confidence: 99%

Coadministration of lanreotide Autogel and pegvisomant normalizes IGF1 levels and is well tolerated in patients with acromegaly partially controlled by somatostatin analogs alone

Lely

Bernabéu

et al. 2011

European Journal of Endocrinology

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Objective: To evaluate the efficacy and safety of coadministered lanreotide Autogel (LA; 120 mg/month) and pegvisomant (40-120 mg/week) in acromegaly. Design: This is a 28-week, multicenter, open-label, single-arm sequential study. Methods: Patients (nZ92) biochemically uncontrolled, on somatostatin analogs (SSAs) or using pegvisomant monotherapy entered a 4-month run-in taking LA (120 mg/month). Patients uncontrolled after the run-in period (nZ57) entered a 28-week coadministration period, receiving LA 120 mg/month plus pegvisomant (60 mg once weekly, adapted every 8 weeks based on IGF1 levels to 40-80 mg once weekly or 40 or 60 mg twice weekly). Results: In total, 33 (57.9%) patients had normalized IGF1 following coadministration (P!0.0001 versus 30% minimum clinically relevant); median pegvisomant dose in normalized patients was 60 mg/week. IGF1 normalized at any time during coadministration in 45 (78.9%) patients (P!0.0001) with median pegvisomant dose at 60 mg/week. Being nondiabetic (odds ratio (OR): 4.65) and older (OR, upper versus lower quartile: 3.40) showed increased likelihood of normalization. Symptom reduction was greatest for arthralgia (K0.6G1.6) and soft tissue swelling (K0.6G1.8).Five patients reported treatment-emergent adverse events causing treatment withdrawal: three serious (treatment related -thrombocytopenia, urticaria; not treatment related -abdominal pain/vomiting) and two nonserious (hepatotoxicity and cytolytic hepatitis, both elevating alanine aminotransferase to O5!upper limit of normal with normalization after withdrawal). Conclusions: In patients partially controlled by SSAs, LA (120 mg/month) plus pegvisomant normalized IGF1 in 57.9% of patients after 7 months, at a median effective pegvisomant dose of 60 mg/week, and 78.9% at any time. In these patients, results suggest a pegvisomant-sparing effect versus daily pegvisomant monotherapy.

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“…Эффекты лечения Соматулином ® Аутожель ® изу -чались как в краткосрочных (до 1 года) [4,7,11,12], так и длительных (до 3 лет) исследованиях в сравнении с Соматулином продленного действия и Сандостатином ЛАР, в которых он показал равнозначную эффективность с препаратами сравнения [4,24,26], что в целом также на-блюдалось на примере представляемой нами пациентки.…”

Section: Discussionunclassified

“…У нашей пациентки мы не наблюдали каких-либо изменений размеров микроаденомы гипофиза при проведении МРТ-исследования через 24 месяца от на-чала лечения, но способность препаратов ланреотида вызывать эффект сжатия опухоли гипофиза заслужи-вает особого внимания [4,7]. В исследовании Alexopoulou О. и соавт.…”

Section: Discussionunclassified

Autozhel' v kontrole biokhimicheskikh markerovaktivnosti akromegalii: predstavlenieklinicheskogo sluchaya

Dzeranova¹,

Giniyatullina²,

Pigarova³

et al. 2010

Obes. metabol.

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Acromegaly is a severe neuroendocrine disease that develops when the pituitary gland produces excess growth hormone (GH). Acromegaly is not only a cosmetic problem. Hypersecretion of GH leads to variety complications, decreased quality of life, shortening the expected lifespan due to development of severe cardiovascular complications. Timely diagnosis and adequate treatment can reduce mortality by 2-5 times and medical therapy deservedly plays an important role in treatment of patients with acromegaly when radical surgical treatment cannot be performed. We present a first Russian experience of acromegaly patient treatment with new preparation - Somatulin Autogel, with analysis of its favorable effects on clinical and metabolic manifestations of the disease.

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Effects of Lanreotide Autogel on Growth Hormone,Insulinlike Growth Factor 1, and Tumor Size in Acromegaly: a 1-Year Prospective Multicenter Study

Cited by 38 publications

References 34 publications

Effects of lanreotide SR and Autogel on tumor mass in patients with acromegaly: a systematic review

Effects of lanreotide SR and Autogel on tumor mass in patients with acromegaly: a systematic review

Coadministration of lanreotide Autogel and pegvisomant normalizes IGF1 levels and is well tolerated in patients with acromegaly partially controlled by somatostatin analogs alone

Autozhel' v kontrole biokhimicheskikh markerovaktivnosti akromegalii: predstavlenieklinicheskogo sluchaya

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