The efficacy and safety of lanreotide Autogel in patients with acromegaly previously treated with octreotide LAR

Ashwell, SG; Bevan, J. S.; Edwards, O. M.; Harris, M; Holmes, Carol; Middleton, MA; James, Rosemary

doi:10.1530/eje.0.1500473

Cited by 52 publications

(38 citation statements)

References 18 publications

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“…This could be due to slight differences in the affinity of both drugs for the somatostatin receptor subtypes (34) or in the pharmacokinetic profiles of the two drugs. In this regard, it appears that at least 6 months may be required for steady state to be reached with L-Autogel treatment in some patients (26). Lastly, a possible direct effect of L-Autogel on IGF-I secretion, independent of GH levels, cannot be firmly excluded.…”

Section: Discussionmentioning

confidence: 99%

“…The present study shows that both somatostatin analogues were well tolerated and similarly effective in the treatment of acromegaly, with minor differences that may alternatively favour one or the other depot formulation. Two recent studies (26,27) have also compared the effects of octreotide LAR and L-Autogel in smaller numbers of acromegalic patients. In a group of 10 patients, in which the disease was well-controlled, switching from LAR 20 mg to L-Autogel 60 -120 mg/4 weeks resulted in similar effects on GH levels, but in a slightly greater reduction of IGF-I after 28 weeks (26), while in another recent 12-month study of seven patients with a good responsiveness to octreotide, no difference in GH and IGF-I suppression was observed between the two long-acting analogues (27).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Alexopoulou¹,

Abrams

Verhelst

et al. 2004

European Journal of Endocrinology

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Objective: This open label, multicentre study was designed to evaluate the efficacy and tolerability of lanreotide Autogel (L-Autogel) in acromegalic patients over a 24-week period. The outcome of treatment with this new, long-acting, aqueous formulation of lanreotide was also compared with the patients' previous treatment with octreotide long acting repeatable (LAR). Design and methods: Twenty-five acromegalic patients (13 males, mean age 51^12 years) were switched from octreotide LAR (20-40 mg/4 weeks for at least 6 months) to L-Autogel, given deep subcutaneously at a fixed dose of 90 mg/4 weeks. After 12 weeks, the dose of L-Autogel was titrated according to patients' mean GH and IGF-I levels at week 8. It was increased to 120 mg/4 weeks if GH . 2.5 mg/l or if IGF-I was above the age-adjusted normal range. It was reduced to 60 mg/4 weeks if mean GH , 1 mg/l and IGF-I was within the normal range. If the values did not fall within these ranges, the dose remained unchanged at 90 mg. Results: After 24 weeks of treatment with L-Autogel (final doses 60 mg in 3 patients, 90 mg in 4 patients and 120 mg in 18 patients), mean serum GH (2.9^2.4 mg/l) and IGF-I concentrations (332^193 mg/l) remained statistically unchanged when compared with baseline values under octreotide LAR (GH 2.4^1.8 mg/l and IGF-I 337^201 mg/l, non significant (NS)). There was a significant improvement of the acromegalic symptom score over the study period, from 4.8^3.4 to 2.8^2.5 (P , 0.001) and a small but significant reduction in the residual pituitary tumour volume (P , 0.05). Local side-effects were observed less frequently and no technical problems were encountered with the L-Autogel injections, as opposed to treatment with octreotide LAR (60 difficult injections/150 (P , 0.001)). Conclusions: L-Autogel appears to be as effective as octreotide LAR in lowering GH and IGF-I concentrations in acromegalic patients. This treatment was also well tolerated by the patients, giving fewer local side-effects and technical problems with injections. These advantages may improve the long-term acceptability of medical treatment in acromegaly.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Alexopoulou¹,

Abrams

Verhelst

et al. 2004

European Journal of Endocrinology

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“…The first study that has assessed this (Petrossians et al (9)) suggests that indeed debulking surgery, even if unsuccessful, improves the post-surgical outcome of somatostatin analogues given post-operatively when compared with pre-operative response in the same patients. Thus pre-operatively, after medical therapy with various somatostatin analogues GH normalisation was achieved in 29% of patients.…”

mentioning

confidence: 99%

“…For the most part the patients were treated with subcutaneous analogues. We know that these are less effective than the long-acting preparations, lanreotide autogel and octreotide LAR (9). Lanreotide is not as effective as octreotide in reducing IGF-I levels to normal but it is probable that octreotide LAR and lanreotide autogel are equally efficacious (10,11).…”

mentioning

confidence: 99%

Debulking of pituitary adenomas improves hormonal control of acromegaly by somatostatin analogues

Wass¹

2005

eur j endocrinol

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“…Two endogenous, biologically active forms of somatostatin are formed by the cleavage of prosomatostatin: SRIF-14 and SRIF-18. 27 Five different somatostatin receptor subtypes, sst [1][2][3][4][5] , have been characterized. These subtypes are 7-transmembrane domain G-protein-coupled receptors.…”

Section: Somatostatin Analogsmentioning

confidence: 99%

Pharmacological management of acromegaly: a current perspective

Manjila

Khan

et al. 2010

FOC

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Acromegaly is a chronic disorder of enhanced growth hormone (GH) secretion and elevated insulin-like growth factor–I (IGF-I) levels, the most frequent cause of which is a pituitary adenoma. Persistently elevated GH and IGF-I levels lead to substantial morbidity and mortality. Treatment goals include complete removal of the tumor causing the disease, symptomatic relief, reduction of multisystem complications, and control of local mass effect. While transsphenoidal tumor resection is considered first-line treatment of patients in whom a surgical cure can be expected, pharmacological therapy is playing an increased role in the armamentarium against acromegaly in patients unsuitable for or refusing surgery, after failure of surgical treatment (inadequate resection, cavernous sinus invasion, or transcapsular intraarachnoid invasion), or in select cases as primary treatment. Three broad drug classes are available for the treatment of acromegaly: somatostatin analogs, dopamine agonists, and GH receptor antagonists. Somatostatin analogs are considered as the first-line pharmacological treatment of acromegaly, although efficacy varies among the different formulations. Octreotide long-acting release (LAR) appears to be more efficacious than lanreotide sustained release (SR). Lanreotide Autogel (ATG) has been shown to result in similar biological control as octreotide LAR, and there may be a benefit in switching from one to the other in some cases of treatment failure. The novel multireceptor somatostatin analog pasireotide, currently in Phase II clinical trials, also shows promise in the treatment of acromegaly. Dopamine agonists have been the earliest and most widely used agents in the treatment of acromegaly but have been found to be less effective than somatostatin analogs. In this class of drugs, cabergoline has shown greater efficacy and tolerability than bromocriptine. Dopamine agonists have the advantage of oral administration, resulting in increased use in select patient groups. Selective GH receptor antagonists, such as pegvisomant, act by blocking the effects of GH, resulting in decreased IGF-I production despite persistent elevation of GH serum levels. Thus far, tumor growth has not been a concern during pegvisomant therapy. However, combination treatment with somatostatin analogs may counteract these effects. The authors discuss the latest guidelines for biochemical cure and highlight the efficacy of combination therapy. In addition, the effects of pharmacological presurgical treatment on surgical outcome are explored.

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The efficacy and safety of lanreotide Autogel in patients with acromegaly previously treated with octreotide LAR

Cited by 52 publications

References 18 publications

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Efficacy and tolerability of lanreotide Autogel therapy in acromegalic patients previously treated with octreotide LAR

Debulking of pituitary adenomas improves hormonal control of acromegaly by somatostatin analogues

Pharmacological management of acromegaly: a current perspective

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