The effect of subcutaneous infusion versus subcutaneous injections of a somatostatin analogue (SMS 201-995) on the diurnal GH profile in acromegaly

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Abstract
Multiple sc injections of a long-acting somatostatin analogue (SMS 201-995) are currently used in the treatment of acromegaly. However, plasma GH concentration often reaches a pathological level (> 5 .mu.g/l) between two injections. In seven patients with active acromegaly we compared, in a short-term trial, the effect of SMS 201-995 administered by continuous sc infusion (50 .mu.g and 100 .mu.g a day) and by three sc injections (100 .mu.g each). In six patients, plasma GH levels were significantly reduced regardless of the mode and dose of treatment (P < 0.05). However, comparing diurnal profiles, 100 .mu.g continuous sc infusion was more effective than discontinuous administration in reducing the number of GH levels above 5 .mu.g/l (P < 0.01). In two patients, continuous infusion was the only way to decrease all plasma GH values below 5 .mu.g/l during the diurnal profile determination. Moreover, even when, in a long-term study, the dose of multiple injections was progressively increased to 500 .mu.g three times a day, GH levels remained consistently elevated in one of these patients. Thus, in some acromegalic patients continuous sc injection seems currently the most efficient way of treatment with SMS 201-995.