Use of long acting somatostatin analogue (Lanreotide) in CHI - its pharmacokinetics and long-term follow-up study

Abstract

• Congenital hyperinsulinism (CHI) causes severe hypoglycaemia in children.• Diazoxide and daily octreotide injections are first and second-line of treatment for CHI respectively.• To evaluate the efficacy, safety and pharmacokinetics of long acting somatostatin analogue (Lanreotide) therapy in CHI patients.• Patients >6 months of age either on high dose diazoxide (causing side effects), or daily octreotide were started on 30mg Lanreotide every 4-weeks.• Children >3 years of age had Paediatric Quality of Life (PedsQL) with Strengths and Difficulties questionnaires (SDQ) and continuous glucose monitoring (CGMS) preand 1-year post-Lanreotide.• Plasma Lanreotide concentrations measured by radioimmunoassay (>3 years of age) at different time points after first dose and subsequently prior to each dose for 6 months.• 31 children were commenced on Lanreotide and 5 had to stop treatment. Out of 26 children, 18 were on daily octreotide and 8 on diazoxide. • PedsQL showed significant change in total health and psychosocial score and significant reduction in overall stress in the SDQ after 1-year post-Lanreotide (p<0.05).• CGMS on 15 children showed significant reduction in hypoglycaemic episodes after 1 year of therapy (p=0.012) (figure 3).