Ferdinand Roelfsema, Nienke R. Biermasz, Alberto M. Pereira and Johannes A. Romijn

Department of Endocrinology and Metabolism, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

Abstract

Background:  In acromegaly expert surgery is curative in only about 60% of patients. Postoperative radiation therapy is associated with a high incidence of hypopituitarism and its effect on GH production is slow, so that adjuvant medical treatment becomes of importance in the management of many patients.

Objective: To delineate the role of lanreotide Autogel^® in the treatment of acromegaly.

Methods:  Search of Medline, Embase and Web of Science databases for clinical lanreotide studies in acromegaly.

Results:  The weighted mean of serum GH normalization by Lanreotide Autogel^®, based on 10 published clinical studies, was 58% in 370 patients. These patients were mostly switched from other somatostatin analogs. Serum IGF-I concentration normalized in 48% of these patients. Three small studies, with a total of 60 patients, compared the efficacy of octreotide LAR and that of lanreotide Autogel^®. The highest dose of lanreotide appeared to be equivalent with 20 mg of octreotide LAR. Observed side effects were comparable with other somatostatin analogs, including octreotide LAR. Due to the lack of studies with previously, non-medically treated, patients no reliable data on tumor shrinkage is available.

Conclusion:  Lanreotide Autogel^®, a latecomer in the second generation of somatostatin analogs, has a therapeutic profile similarte octreotide LAR, which is now in clinical use for more than a decade. Preference for one of the drugs is dictated by the physician, patient and the cost of the drug.