Efficacy of Octreotide-lar versus Surgery in Treating Acromegaly

Research studyThere are several treatment options for patients with acromegaly.  A recent study looked at two treatments in particular:  octreotide-lar (Oct-LAR) and surgery.  The researchers wanted to see how well the treatments control IFG-1 levels, GH levels, and tumor volumes; they also examined the side effects of the treatments.

This was a randomized, prospective study involving 22 patients.  The results were published in the November 2011 issue of Clinical Endocrinology (Oxford) in an article called “Comparison of primary octreotide-lar and surgical treatment in newly diagnosed patients with acromegaly.”

The patients were consecutively randomized to either the Oct-LAR or surgery group.  The following were obtained at baseline:

  • serum IGF-1 level
  • GH level
  • tumor volume

These were comparable in both groups.

At 3 months and 6 months, there weren’t any significant differences between the groups in terms of IGF-1 levels and GH levels.  However, at 12 months, the pre-glucose GH level was lower in the surgery group.

In the Oct-LAR group, tumor volume reduction was:  26% (3 months), 30% (6 months), and 31% (12 months).

In the surgery group, tumor volume reduction was:  64% (3 months), 74% (6 months), and 79% (12 months).

In conclusion, the researchers say that surgery seems to be slightly more effective than Oct-LAR for patients with acromegaly who have non-invasive tumors.  Also, it should be noted that Oct-LAR is associated with more side effects, including cholelithiasis, and it is more costly than surgery.

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