THERAPY OF ACROMEGALY WITH SANDOSTATIN: THE PREDICTIVE VALUE OF AN ACUTE TEST, THE VALUE OF SERUM SOMATOMEDIN‐C MEASUREMENTS IN DOSE ADJUSTMENT AND THE DEFINITION OF A BIOCHEMICAL ‘CURE’

Publisher Website
Google Scholar
Abstract
Fifteen acromegalic patient were treated for a mean of 96 weeks with 200–300 μg Sandostatin per day. The mean 24 h GH concentration decreased by 86% from 34.3 ± 6.6 to 4.8 ± 0.7 μ/l (1 μg/l = 46 pmol/1). There was a close correlation between the mean GH levels from 2 to 6 h after the acute administration of 50 μg Sandostatin and the mean 24 h GH levels after chronic therapy (P < 001). Serum Sm-C levels decreased from 6.9 ± 0.7 to 2.7 ± 0.5 U/ml (−61%) and normalized in eight of these 15 patients. There was a close correlation between the Sm-C and mean 24 h GH levels after therapy (P < 0001). It is suggested that adjustment of the dose and the number of Sandostatin injections can be made in acromegaly on the basis of the measurement of Sm-C levels during the follow-up. This precludes the need of multiple GH determinations throughout the day and/or night. Biochemical ‘cure’(as denned by normalized Sm-C levels) was reached in eight patients in whom mean 24 h GH levels were suppressed to 3–3 μg/l or less. The normalization of Sm-C levels was even observed in the presence of two or three GH secretory peaks (never exceeding 7.5–10 μg/l) during the 24 h period occurring towards the next Sandostatin injection.