Objective: In this study, the effect of high-dose octreotide LAR on glucose metabolism in patients with acromegaly was investigated. Design: A post-hoc analysis of a clinical trial enrolling 26 patients with acromegaly not controlled by standard maximal somatostatin analog (SSAs) dose and randomized to receive high-dose (60 mg/28 days) or high-frequency (30 mg/21 days) octreotide i.m. injection (octreotide LAR) for 6 months. Methods: Glucose metabolic status was defined as worsened when a progression from normoglycemia to impaired fasting glucose (IFG) or from IFG to diabetes occurred or when an increase of HbAlc by at least 0.5% was demonstrated. An improvement of glucose metabolism was defined in the presence of a regression from IFG to normoglycemia and/or when HbAlc decreased by at least 0.5%. Results: Glucose metabolic status remained unchanged in a majority of patients (16/26 patients, 65.3%), worsened in six patients, and improved in four patients. Pre-existing metabolic status did not predict worsening of glucose metabolism, which, conversely, was significantly related to persistent biochemical activity of the disease. In fact, patients with worsened glucose metabolism exhibited a less frequent decrease in serum GH and IGF1 levels, compared with patients with improved or unchanged glucose metabolism (2/6 vs 18/20; P=0.01). Conclusion: An increase in octreotide LAR dose or frequency did not impact on glucose metabolism in most patients. Worsening of glucose metabolic status occurred in close relation with persistently uncontrolled acromegaly. © 2011 European Society of Endocrinology.

Mazziotti, G., Porcelli, T., Bogazzi, F., Bugari, G., Cannavò, S., Colao, A., Cozzi, R., De Marinis, L., Degli Uberti, E., Grottoli, S., Minuto, F., Montini, M., Spinello, M., Giustina, A., Effects of high-dose octreotide lar on glucose metabolism in patients with acromegaly inadequately controlled by conventional somatostatin analog therapy, <<EUROPEAN JOURNAL OF ENDOCRINOLOGY>>, 2011; 164 (3): 341-347. [doi:10.1530/EJE-10-0811] [http://hdl.handle.net/10807/7024]

Effects of high-dose octreotide lar on glucose metabolism in patients with acromegaly inadequately controlled by conventional somatostatin analog therapy

Porcelli, Teresa;De Marinis, Laura;
2011

Abstract

Objective: In this study, the effect of high-dose octreotide LAR on glucose metabolism in patients with acromegaly was investigated. Design: A post-hoc analysis of a clinical trial enrolling 26 patients with acromegaly not controlled by standard maximal somatostatin analog (SSAs) dose and randomized to receive high-dose (60 mg/28 days) or high-frequency (30 mg/21 days) octreotide i.m. injection (octreotide LAR) for 6 months. Methods: Glucose metabolic status was defined as worsened when a progression from normoglycemia to impaired fasting glucose (IFG) or from IFG to diabetes occurred or when an increase of HbAlc by at least 0.5% was demonstrated. An improvement of glucose metabolism was defined in the presence of a regression from IFG to normoglycemia and/or when HbAlc decreased by at least 0.5%. Results: Glucose metabolic status remained unchanged in a majority of patients (16/26 patients, 65.3%), worsened in six patients, and improved in four patients. Pre-existing metabolic status did not predict worsening of glucose metabolism, which, conversely, was significantly related to persistent biochemical activity of the disease. In fact, patients with worsened glucose metabolism exhibited a less frequent decrease in serum GH and IGF1 levels, compared with patients with improved or unchanged glucose metabolism (2/6 vs 18/20; P=0.01). Conclusion: An increase in octreotide LAR dose or frequency did not impact on glucose metabolism in most patients. Worsening of glucose metabolic status occurred in close relation with persistently uncontrolled acromegaly. © 2011 European Society of Endocrinology.
2011
Inglese
Mazziotti, G., Porcelli, T., Bogazzi, F., Bugari, G., Cannavò, S., Colao, A., Cozzi, R., De Marinis, L., Degli Uberti, E., Grottoli, S., Minuto, F., Montini, M., Spinello, M., Giustina, A., Effects of high-dose octreotide lar on glucose metabolism in patients with acromegaly inadequately controlled by conventional somatostatin analog therapy, <<EUROPEAN JOURNAL OF ENDOCRINOLOGY>>, 2011; 164 (3): 341-347. [doi:10.1530/EJE-10-0811] [http://hdl.handle.net/10807/7024]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/7024
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact