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Optimalization and cost management of lanreotide-Autogel therapy in acromegaly

Department of Endocrinology, University Hospital of Antwerp, Wilrijkstraat 1, B-2650 Antwerp, Belgium
¹ Department of Endocrinology, UCL-St Luc Hospital, Brussels, Belgium
² Department of Endocrinology, Middelheim Hospital, Antwerp, Belgium

(Correspondence should be addressed to P Abrams Email: pascale.abrams{at}uza.be)

Background: Lanreotide-Autogel is a depot formulation of the somatostatin analog lanreotide used in the treatment of acromegaly. We investigated whether prolonging or shortening the interval between injections would offer any benefit.

Subjects and methods: The interval was prolonged from once every 4 weeks to once every 6 weeks when patients (n=9) had normal IGF-I and GH concentrations. When patients (n=12) had still elevated IGF-I or GH on the maximal dose of 120 mg every 4 weeks, the interval was shortened to once every 3 weeks. Serum IGF-I and GH were measured after 12 and 24 weeks to allow for dose adaptation. Symptoms and tumor volume were evaluated at baseline and after 36 weeks.

Results: In seven of the nine subjects with normal IGF-I and GH, the interval could be extended to 6 weeks without loosing efficacy on IGF-I (195 vs 213 µg/l; not significant, NS) and GH concentrations (1.4 vs 1.3 µg/l; NS). The weekly dose could significantly be reduced (from 23.3 to 17.8 mg; P=0.002). In only 1 of the 12 not-controlled patients, reducing the interval to once every 3 weeks induced normalization of IGF-I and GH.

Conclusion: In subjects whose acromegaly is well controlled using lanreotide-Autogel, prolonging the time interval between injections can often be increased 4 to 6 weeks without loss of efficacy, thereby improving the subject's comfort and reducing the cost of treatment. On the other hand, in subjects whose acromegaly is not controlled on a dose of 120 mg every 4 weeks, reducing the interval to every 3 weeks is rarely beneficial.

This article has been cited by other articles:

				R. D. Murray and S. Melmed A Critical Analysis of Clinically Available Somatostatin Analog Formulations for Therapy of Acromegaly J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2957 - 2968. [Abstract] [Full Text] [PDF]