Effects of long-acting Somatostatin analog on Growth hormone levels in acromegaly patients after incomplete surgery

Abstract

Background: Acromegaly is a rare clinical syndrome associated with high levels of growth hormone.

The most common cause is tumor (adenoma) secrets growth hormone from the anterior pituitary (representing 95% of the causes).

Surgical treatment -especially Trans-sphenoidal surgery- is the first line therapy for acromegaly but due to the variation of its successful rates, there is a need to study the role of medical treatment in improving the results after incomplete surgery.

Objective: To study the effect of long acting somatostatin analog -Octreotide- in reducing Growth hormone (GH) and Insulin-like growth factor (IGF-1) levels at the end of treatment.

Methods: A retrospective study included 30 patients diagnosed with acromegaly who had unsuccessful surgery –whether trans-sphenoidal or trans-cranial- admitted to the endocrinology department at Al-Mowasat University Hospital in Damascus to be treated with long-acting Octreotide 30 mg monthly. Hormonal evaluation for Growth hormone (GH) and Insulin-like growth factor (IGF-1) had been done at baseline, after 3 months and at the end of treatment duration, which ranged from 5-11 months (mean of 6.4 months).

Results: There was a strong statistically effect of Octreotide in reducing mean basal levels of GH and IGF-1 at the end of treatment and achieving GH control (GH less than 2.5 ng\ml) in 40%, IGF-1 control (normal for age and sex) in 40% and complete control (GH > 2.5 ng/ml with normal IGF-1) in 33.3% of patients. A significant decrease of GH and IGF-I levels was accomplished by the third month compared to baseline levels.

Conclusion: There is an important role of Octreotide in hormonal control and decreasing GH and IGF-1 levels especially after three months of treatment.