Long-Term Primary Medical Therapy with Somatostatin Analogs in Acromegaly
Resource
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION v.105 n.8 pp.664-669
Journal
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
Journal Volume
v.105
Journal Issue
n.8
Pages
664-669
Date Issued
2006
Date
2006
Author(s)
SU, DENG-HUANG
LIAO, KUO-MENG
CHEN, HUAN-WEN
CHANG, TIEN-CHUN
Abstract
To cure acromegalic patients, transsphenoidal surgery is considered first , especially for microadenoma. However, less than 50% of patients with macroadenoma achieve satisfactory biochemical control. Moreover, surgery may cause hypopituitarism. Medical therapy may offer the prospect of near normalization of growth hormone (GH)/insulin-like growth factor-1 levels with substantial tumor shrinkage in a significant number of patients. Here , we report two cases of acromegaly under treatment with somatostatin analogs alone for more than 10 years. Case 1 was a 54-year-old man with a pituitary macroadenoma. He received 4 years of octreotide treatment followed by 6 years of prolonged- release (PR) lanreotide resulting in normal GH level. Case 2 was a 60-year-old woman with a 1.3 cm pituitary tumor. She received 8 years of octreotide treatment followed by 6 years of PR lanreotide resulting in subnormal GH level and gallbladder sludge. She had received bilateral total hip replacement for hip osteoarthritis at the age of 59 years. These cases illustrate that long-term treatment with somatostatin analogs offers an alternative choice in selected acromegalic patients, such as those with pituitary tumor who cannot be cured by surgery, those who have unacceptable anesthetic risk and those who refuse surgery.
Subjects
acromegaly
lanreotide
octreoticle
somatostatin analog
therapy
Type
journal article