The effect of subcutaneous infusion versus subcutaneous injections of a somatostatin analogue (SMS 201-995) on the diurnal GH profile in acromegaly

Abstract

Abstract. Multiple sc injections of a long-acting somatostatin analogue (SMS 201-995) are currently used in the treatment of acromegaly. However, plasma GH concentration often reaches a pathological level (> 5 μg/l) between two injections. In seven patients with active acromegaly we compared, in a short-term trial, the effect of SMS 201-995 administered by continuous sc infusion (50 μg and 100 μg a day) and by three scinjections (100 μg each). In six patients, plasma GH levels were significantly reduced regardless of the mode and dose of treatment (P < 0.05). However, comparing diurnal profiles, 100 μg continuous sc infusion was more effective than discontinuous administration in reducing the number of GH levels above 5 μg/l (P < 0.01). In two patients, continuous infusion was the only way to decrease all plasma GH values below 5 μg/l during the diurnal profile determination. Moreover, even when, in a long-term study, the dose of multiple injections was progressively increased to 500 μg three times a day, GH levels remained consistently elevated in one of these patients. Thus, in some acromegalic patients continuous sc injection seems currently the most efficient way of treatment with SMS 201-995.