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Article: Comparison of the effectiveness of 2-hourly versus 8-hourly subcutaneous injections of a somatostatin analog (SMS 201-995) in the treatment of acromegaly

TitleComparison of the effectiveness of 2-hourly versus 8-hourly subcutaneous injections of a somatostatin analog (SMS 201-995) in the treatment of acromegaly
Authors
Issue Date1989
PublisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org
Citation
Journal Of Clinical Endocrinology And Metabolism, 1989, v. 69 n. 3, p. 670-677 How to Cite?
AbstractTo determine whether sc injections of a somatostatin analog (SMS 201-995) every 2 h (q2h) is more effective than sc injections every 8 h (q8h) in achieving a constant suppression of GH levels and a more satisfactory clinical response, we studied 10 patients with acromegaly (4 newly diagnosed and 6 previously treated with bromocriptine/pituitary irradiation/transfrontal hypophysectomy). The dose of SMS 201-995 was increased from 300 μg/day to a maximum of 600 μg/day when the mean serum GH (hourly samples for 12 h) failed to be suppressed to undetectable levels in over 75% of the samples. Five patients received a 200-μg sc injection q8h (600 μg/day), and the other 5 received sc injections q2h [418 ± 46 μg/day (mean ± Se); range, 288-504 μg/day]. In the group receiving q2h sc SMS 201-995 there was a marked suppression of mean GH from a basal level of 77.3 ± 24.7 mU/l to less than 5 mU/L in all five subjects. In the group receiving q8h sc SMS 201-995, mean GH was suppressed from a basal level of 82.2 ± 21.7 to 15.4 ± 3.3 mU/L after 6 months of therapy, and none of the patients had a mean GH level consistently less than 5 mU/L. Despite the difference in the level of GH suppression, mean serum somatomedin-C levels were decreased promptly in both groups of subjects. Associated with the decrease in somatomedin-C levels there was a marked clinical response in both groups, but improvement in clinical features and decreases in hand volumes and ring size occurred earlier in the group receiving SMS 201-995 q2h. Significant tumor shrinkage (25% to >50% reduction) was observed in two patients receiving q2h injections, while a 25-50% reduction in tumor size was noted in another patient receiving q8h injections. Because of the small doses of SMS 201-995 used side-effects of abdominal discomfort and flatulence were mild and rapidly disappeared. Our results show that increasing the frequency of sc administration of the somatostatin analog from q8h to q2h leads to more marked and consistent suppression of GH levels and more rapid improvement of clinical signs. Increasing the frequency of delivery of SMS 201-995 may be an alternative to increasing the dose in some patients with acromegaly.
Persistent Identifierhttp://hdl.handle.net/10722/161792
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, Cen_US
dc.contributor.authorLam, KSLen_US
dc.contributor.authorArceo, Een_US
dc.contributor.authorChan, FLen_US
dc.date.accessioned2012-09-05T05:15:04Z-
dc.date.available2012-09-05T05:15:04Z-
dc.date.issued1989en_US
dc.identifier.citationJournal Of Clinical Endocrinology And Metabolism, 1989, v. 69 n. 3, p. 670-677en_US
dc.identifier.issn0021-972Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/161792-
dc.description.abstractTo determine whether sc injections of a somatostatin analog (SMS 201-995) every 2 h (q2h) is more effective than sc injections every 8 h (q8h) in achieving a constant suppression of GH levels and a more satisfactory clinical response, we studied 10 patients with acromegaly (4 newly diagnosed and 6 previously treated with bromocriptine/pituitary irradiation/transfrontal hypophysectomy). The dose of SMS 201-995 was increased from 300 μg/day to a maximum of 600 μg/day when the mean serum GH (hourly samples for 12 h) failed to be suppressed to undetectable levels in over 75% of the samples. Five patients received a 200-μg sc injection q8h (600 μg/day), and the other 5 received sc injections q2h [418 ± 46 μg/day (mean ± Se); range, 288-504 μg/day]. In the group receiving q2h sc SMS 201-995 there was a marked suppression of mean GH from a basal level of 77.3 ± 24.7 mU/l to less than 5 mU/L in all five subjects. In the group receiving q8h sc SMS 201-995, mean GH was suppressed from a basal level of 82.2 ± 21.7 to 15.4 ± 3.3 mU/L after 6 months of therapy, and none of the patients had a mean GH level consistently less than 5 mU/L. Despite the difference in the level of GH suppression, mean serum somatomedin-C levels were decreased promptly in both groups of subjects. Associated with the decrease in somatomedin-C levels there was a marked clinical response in both groups, but improvement in clinical features and decreases in hand volumes and ring size occurred earlier in the group receiving SMS 201-995 q2h. Significant tumor shrinkage (25% to >50% reduction) was observed in two patients receiving q2h injections, while a 25-50% reduction in tumor size was noted in another patient receiving q8h injections. Because of the small doses of SMS 201-995 used side-effects of abdominal discomfort and flatulence were mild and rapidly disappeared. Our results show that increasing the frequency of sc administration of the somatostatin analog from q8h to q2h leads to more marked and consistent suppression of GH levels and more rapid improvement of clinical signs. Increasing the frequency of delivery of SMS 201-995 may be an alternative to increasing the dose in some patients with acromegaly.en_US
dc.languageengen_US
dc.publisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.orgen_US
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolismen_US
dc.subject.meshAcromegaly - Blood - Drug Therapy - Physiopathologyen_US
dc.subject.meshAdulten_US
dc.subject.meshBlood Glucose - Analysisen_US
dc.subject.meshClinical Trials As Topicen_US
dc.subject.meshDrug Administration Scheduleen_US
dc.subject.meshFemaleen_US
dc.subject.meshGrowth Hormone - Blooden_US
dc.subject.meshHemoglobin A, Glycosylated - Analysisen_US
dc.subject.meshHumansen_US
dc.subject.meshInjections, Subcutaneousen_US
dc.subject.meshInsulin - Analysisen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOctreotide - Administration & Dosage - Therapeutic Useen_US
dc.titleComparison of the effectiveness of 2-hourly versus 8-hourly subcutaneous injections of a somatostatin analog (SMS 201-995) in the treatment of acromegalyen_US
dc.typeArticleen_US
dc.identifier.emailLam, KSL:ksllam@hku.hken_US
dc.identifier.authorityLam, KSL=rp00343en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1210/jcem-69-3-670-
dc.identifier.pmid2668325-
dc.identifier.scopuseid_2-s2.0-0024466639en_US
dc.identifier.volume69en_US
dc.identifier.issue3en_US
dc.identifier.spage670en_US
dc.identifier.epage677en_US
dc.identifier.isiWOS:A1989AL41000029-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, C=7501631357en_US
dc.identifier.scopusauthoridLam, KSL=8082870600en_US
dc.identifier.scopusauthoridArceo, E=6506868855en_US
dc.identifier.scopusauthoridChan, FL=7202586444en_US

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