3-YEAR FOLLOW-UP OF ACROMEGALIC PATIENTS TREATED WITH INTRAMUSCULAR SLOW-RELEASE LANREOTIDE

Somatostatin analogs are an alternative treatment to pituitary surgery and radiotherapy in acromegalic patients. Recently, a depot long-last ing formulation of slow release (SR) lanrectide has been shown to be e ffective in the short-term control of GH hypersecretion in acromegalic patients. We report the long-term follow-up of a cohort of 22 acromeg alic patients treated with SR lanreotide during 1-3 yr. Thirteen femal es and 9 males, age 51 +/- 3 yr, presented with macroadenomas (n = 12) , microadenomas (n = 8), or empty sella (n = 2). Seven patients previo usly had undergone a partial surgical removal of their adenomas, and 2 1 of them has mean plasma GH levels less than 5 mu g/L during a previo us octreotide treatment. According to GH values recorded after 3 month s of twice monthly 30 mg SR lanreotide im injection, SR lanreotide was administered every 14 days (n = 13) or every 10 days (n = 9). At the 6-month visit, mean GH values were 5 mu g/L or less in 68% and 2.5 mu g/L or less in 27% of patients, and these results remained unchanged d uring the 1-3 yr follow-up period. During SR lanreotide treatment, the mean insulin-like growth factor I (IGF-I) concentrations remained in the normal range in 63% of patients. No escape from the treatment occu red in any of the cases. A significant decrease of the pituitary tumor volume was observed in 3 (13%) patients. The main side effect consist ed of minor digestive problems during 48 h after each injection and wa s reported by 13 patients. Biannual gallbladder echographies revealed the occurence of gallstones in 4 (18%) patients. In conclusion, these data confirms the efficacy and the tolerance of the long-term SR lanre otide administration (30 mg im every 10-14 days) in the control of acr omegaly.