Intramuscular injections of slow-release lanreotide (BIM 23014) in acromegalic patients previously treated with continuous subcutaneous infusion of octreotide (SMS 201-995)

Abstract

Caron P, Cogne M, Gusthiot-Joudet B, Wakim S, Catus F, Bayard F. Intramuscular injections of slowrelease lanreotide (BIM 23014) in acromegalic patients previously treated with continuous subcutaneous infusion of octreotide (SMS 201-995). Eur J Endocrinol 1995;132:320–5. ISSN 0804–4643 Nine acromegalic patients (five females and four males), mean age 50 ± 4 years, presented macroadenomas (N = 7), microadenoma (N = 1) or normal computed tomography scans (N = 1). Patients were treated with continuous subcutaneous infusion of octreotide (range 200–600 μg/day). Following a washout period of 7 days, the patients were injected im with 30 mg slow-release lanreotide every 10 days for the first month and then twice monthly. In case of elevated growth hormone (GH) levels at 3 months, the patients were injected every 10 days for the next three months. Plasma GH and insulin-like growth factor I (IGH-I) decreased in all patients during octreotide treatment. After 6 months of octreotide treatment, seven patients were considered as well controlled (mean 8 h GH < 5 μg/l, IGF-I normal) whereas in two patients the mean 8-h GH and/or IGF-I levels remained increased. Serum GH and IGH-I increased after octreotide withdrawal. In one patient, serum GH and IGF-I increased during slow-release lanreotide administration and injections were stopped after 45 days. After 3 months of lanreotide, three patients were well controlled while in five patients GH or IGF-I levels were not normalized. At 6 months, five patients were injected twice monthly and three patients had one injection every 10 days. Six patients were well controlled and in two patients the mean 8-h GH level remained increased. The pituitary tumor volume decreased by 20–30% in two patients during octreotide, as well as in one other during slow-release lanreotide therapy. Slow-release lanreotide was well tolerated except for minor digestive problems during the early days of treatment or mild pain at the site of injection. Gallbladder echographies were normal during octreotide and lanreotide therapies, except in one patient in whom gallstones occurred during octreotide treatment. In conclusion, this clinical study shows that in acromegalic patients, im injections of slow-release lanreotide (two or three per month) are well tolerated and are as effective as continuous subcutaneous infusion of octreotide in the control of GH hypersecretion. Therefore, slow-release lanreotide would appear to be a useful therapeutic tool to improve the quality of life in patients with acromegaly. Philippe Caron, Service d'Endocrinologie et Maladies métaboliques, CHU Rangueil, 1 Avenue J Poulhés, 31054 Toulouse Cedex, France