Long-term treatment of acromegaly with octreotide

In order to confirm the effectiveness and tolerability of octreotide in acromegaly, we studied seven patients (4 women, 3 men) after unsuccessful surgery and radiotherapy performed for pituitary adenomas. The patients (29.6±7.9 yr) were treated with octreotide at doses of 300-1500 μg daily for 12 months. Hormonal profiles and ultrasonographic evaluation of gallbladder were performed before the treatment, after 1 month, and subsequently at intervals of 36 months. The GH fell from a basal level of 18.5±8.3 ng/ml to 77±4.3 ng/ml after 1 month (p<0.01). At 3 month, the mean GH was 5.4±2.6 and at 6 months 5.2±2.1 and at 12 months 5.5±3.1 ng/ml (all p<0.02). During therapy T₃ levels decreased from 1.3±0.2 ng/ml to 1.0±0.2 ng/ml (p<O.02), wherease T₄ and TSH levels remained unchanged. No changes were seen in serum HbA1, cortisol and osteocalcin. The systolic and the diastolic blood pressure decreased from the pretreatment level of 122.8±7.5 and 83.6±4.7 mmHg respectively to 107.1±18.9 (p<0.04) and 70.0±14.1mmHg (p<0.02) respectively at 1 month. Perspiraton, fatigue, arthralgia, headache, soft tissue swelling and paresthesia were improved in all patients. The drug was generally well tolerated, An increase in intestinal peristaltism and bowel movement occured in the first week, but symptoms later subsided. Gallstones developed in one of these patients after 12 months. Our suggests that octreotide is an effective and relatively safe for treating acromegaly.