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Titolo:
Variable growth hormone profiles following withdrawal of long-term 30 mg slow-release lanreotide treatment in acromegalic patients: clinical implications
Autore:
Caron, P; Tabarin, A; Cogne, M; Chanson, P; Jaquet, P;
Indirizzi:
CHU Rangueil, Dept Endocrinol, Serv Endocrinol & Malad Metab, F-31054 Toulouse, France CHU Rangueil Toulouse France F-31054 lad Metab, F-31054 Toulouse, France CHU Haut Leveque, Bordeaux, France CHU Haut Leveque Bordeaux FranceCHU Haut Leveque, Bordeaux, France CHU Kremlin Bicetre, Paris, France CHU Kremlin Bicetre Paris FranceCHU Kremlin Bicetre, Paris, France CHU Timone, Marseille, France CHU Timone Marseille FranceCHU Timone, Marseille, France
Titolo Testata:
EUROPEAN JOURNAL OF ENDOCRINOLOGY
fascicolo: 6, volume: 142, anno: 2000,
pagine: 565 - 571
SICI:
0804-4643(200006)142:6<565:VGHPFW>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANALOG SMS 201-995; SECRETING PITUITARY-TUMORS; SUBCUTANEOUS INFUSION; OCTREOTIDE; MUTATIONS; BIM-23014; SMS-201-995; MULTICENTER; INJECTIONS; RESPONSES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Caron, P CHU Rangueil, Dept Endocrinol, Serv Endocrinol & Malad Metab, 1 Ave J Poulhes, F-31054 Toulouse, France CHU Rangueil 1 Ave J Poulhes Toulouse France F-31054 use, France
Citazione:
P. Caron et al., "Variable growth hormone profiles following withdrawal of long-term 30 mg slow-release lanreotide treatment in acromegalic patients: clinical implications", EUR J ENDOC, 142(6), 2000, pp. 565-571

Abstract

Objective: Intramuscular injections of 30 mg slow-release (SR) lanreotide (every 10 to 14 days) are an effective treatment in acromegalic patients. Because of an ongoing need to assess the efficacy and the tolerance of a newformulation of a depot preparation of lanreotide, we have evaluated prospectively GH profiles following withdrawal of 30 mg slow-release lanreotide in a cohort of acromegalic patients. Patients: Fifty-one acromegalic patients. controlled during long-term 30 mg SR lanreotide treatment (GH: 1.44 +/- 0.64 mu g/l, IGF-I: 316 +/- 145 ng/ml) (mean I S.D.), were studied following the withdrawal of the drug. Measurements: Mean GH (half-hour samples, 0800-1200h), IGF-I and lanreotide levels were evaluated 14, 28, and 42 days following the last 30 mg SR lanreotide injection. Results: Mean GH levels remained below 2.5 mu g/l in 32 patients (group 1)twenty-eight days following SR lanreotide withdrawal. In these patients, mean GH and IGF-I levels had increased from 1.2 +/- 0.6 to 1.7 +/- 0.5 mu g/l (P < 0001), and from 283 +/- 138 to 359 +/- 168 ng/ml (P < 0.001) respectively. In the 19 other patients (group 2), mean GH concentrations had risenabove 2.5 mu g/l at 28 days following SR lanreotide withdrawal. Mean GH and IGF-I levels had increased from 1.9 +/- 0.4 to 5.1 +/- 2.8 mu g/l (P < 0.001), and from 371 +/- 143 to 568 +/- 206 ng/ml (P < 0.001) respectively, Patients of groups 1 and 2 were comparable with regard to age, sex, tumoral status, mean GH levels before somatostatin analogue treatment, and previoustreatments such as radiotherapy and duration of somatostatin analogue therapy, but 75% of group 1 patients underwent surgery compared with 37% of group 2 patients (P < 0.01). Twenty-eight days following SR lanreotide withdrawal, mean lanreotide levels in group 1 and group 2 had decreased from 1.6 +/- 0.7 to 0.6 +/- 0.3 ng/ml (P < 0.001), and from 2.7 +/- 2.0 to 0.7 +/- 0.7 ng/ml (P < 0.001) respectively. A negative correlation was observed between the lanreotide levels and GH and IGF-I concentrations in the two groups of patients, but the inhibition of GH/IGF-I concentrations by lanreotide levels was higher in group 1 patients than in those of group 2, Six patients of group 1 were treated with 30 mg SR lanreotide injected at monthly intervals. During monthly follow-up, mean GH levels increased above 2.5 mu g/l in2 patients. After 12 months follow-up, mean GH and IGF-I levels from 4 other patients were similar to those obtained with previous therapeutic sequence (i.e. intramuscular injections every 14 days). Conclusion: The degree of responsiveness to lanreotide and the duration ofsomatotroph suppression following lanreotide withdrawal are variable in acromegalic patients controlled during long-term 30 mg SR lanreotide treatment. In patients displaying high sensitivity to lanreotide, the interval between i.m. 30 mg SR lanreotide injections can be increased to one month, thusreducing the cost of the therapy, without altering its efficacy upon GH/IGF-I control.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/12/20 alle ore 14:26:51