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Monotherapy with lanreotide depot for acromegaly: long-term clinical experience in a pituitary center

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Abstract

Purpose

Long-acting somatostatin analogs are one of the main classes of medical therapy used for acromegaly and most patients require ongoing treatment. Few studies have evaluated the long-term efficacy and safety of lanreotide depot beyond 2 years. The goal of this study was to provide a long-term longitudinal assessment of efficacy and safety of lanreotide depot in lanreotide responders compared to a surgically cured control group.

Methods

In this retrospective longitudinal case-control study, patients with acromegaly receiving lanreotide depot monotherapy continuously for at least 24 months (N = 24) and surgically cured patients (N = 39) were compared. Serum IGF-1, pituitary MRIs, lanreotide dose, co-morbidities and adverse effects were assessed longitudinally.

Results

In the lanreotide group, IGF-1 remained normal and unchanged over 6 years; comparable to the surgery only group. There was no difference in prevalence of normal IGF-1 between the lanreotide and surgery only groups at 6 months (100 vs. 97 %), 6 years (89 vs. 90 %) and at last follow-up (96 vs. 92 %). Tumor size remained stable (79 %) or decreased (21 %) in the lanreotide group. In the surgery only group, tumor size remained unchanged in all patients. Hemoglobin A1C did not differ between lanreotide and surgery only groups (baseline 5.8 vs. 6.1 %; last follow-up 6.0 vs. 5.7 %). Two (8 %) of the lanreotide and none of the surgery only group developed new diabetes mellitus.

Conclusion

Lanreotide depot maintains normalization of IGF-1 in 89 % of responders after 6 years, comparable to surgically cured controls, and controlled tumor size in all without significant adverse effects.

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Acknowledgments

This study was supported by an investigator-initiated grant from Ipsen.

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Authors and Affiliations

  1. Neuroendocrine Unit, Neuroendocrine Clinical Center, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 112, Boston, MA, 02114, USA

    Babak Torabi Sagvand, Shafaq Khairi, Arezoo Haghshenas, Nicholas A. Tritos, Karen K. Miller, Anne Klibanski & Lisa B. Nachtigall

  2. Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

    Brooke Swearingen

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  1. Babak Torabi Sagvand
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  2. Shafaq Khairi
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Correspondence to Lisa B. Nachtigall.

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Sagvand, B.T., Khairi, S., Haghshenas, A. et al. Monotherapy with lanreotide depot for acromegaly: long-term clinical experience in a pituitary center. Pituitary 19, 437–447 (2016). https://doi.org/10.1007/s11102-016-0724-3

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