Growth Hormone Rebound After Cessation of SMS 201-995 Treatment in Acromegaly

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Abstract
We studied a 42-year-old women who had persistent active acromegaly despite conventional therapies. She was reated for 6 months with SMS 201-995. Her mean plasma growth hormone GH values decreased during treatment from 9.1 .+-. 1.2 to 6.5 .+-. 1.2 .mu.g/L. One month after the withdrawal of SMS 201-995, the plasma GH level increased to 24.4 .mu.g/L (P < 0.001). This elevation was clinically silent and transitory, as GH levels decreased 8 months later to 6.9 .+-. 1.3 .mu.g/L. Furthermore, at the beginning of therapy, her intractable headache was completely relieved; however, it progressively resumed under therapy. In conclusion, cessation of SMS 201-995 may be followed in some acromegalic patients by a rebound of plasma GH levels. This rebound suggests that SMS 201-995 decreased GH levels by an inhibition of its release from the pituitary. Furthermore, SMS 201-995 may relieve intractable headache in some acromegalic patients, but tolerance to the analgesic effect may develop.