Treatment of Chinese acromegaly with a combination of bromocriptine and octreotide

Background: Good results have been reported with combined use of octreotide and bromocriptine in acromegalic Caucasians. Data concerning the efficacy and tolerability of this combination treatment in Chinese acromegalic patie nts are scanty. Aim: The aim of this study was to assess the efficacy and tolerability of c ombined therapy using bromocriptine and octreotide in the treatment of acro megaly in Chinese patients and to compare the cost-effectiveness of various regimes. Methods: Sixteen Chinese acromegalic patients with growth hormone (GH) conc entration not suppressible to below 5 mU/L (2 mu g/L) during an extended OG TT were recruited to undergo four phases of the study. During the study per iod, the patients were given bromocriptine alone, bromocriptine and low dos e octreotide, bromocriptine and medium dose octreotide, and medium dose oct reotide alone. Plasma concentrations of GH and insulin-like growth factor-1 (IGF-1) were measured before and after the completion of each phase. Results: The number of patients reaching target GH concentrations was signi ficantly higher when treated with octreotide compared to baseline (p<0.05). Bromocriptine alone had a significant effect but not to the extent of octr eotide alone. A combination of low dose octreotide and bromocriptine is as efficacious in the treatment of acromegaly as high dose octreotide. None of the patients suffered from serious adverse effects. Conclusion: The results confirmed the usefulness and tolerability of bromoc riptine and octreotide in Chinese acromegalics. The most cost-effective reg ime in this study was a combination of low dose octreotide and bromocriptin e.