Dose-extension of somatostatin analogues maintains control in acromegaly and saves cost

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 88-129-Acromegaly & Prolactinoma
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-101
Viv Thornton-Jones*1, Alex Vincent2, Niki Karavitaki2, Ashley Grossman3 and John A. H. Wass2
1Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxon, United Kingdom, 2Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, United Kingdom, 3Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom
Background: We have previously reported that somatostatin analogues (SSAs) can be administered less frequently without loss of control of the disease in patients with acromegaly.

Aim: To determine the percentage of patients with acromegaly treated with SSA who received their SSA  treatment less frequently than 4 weeks while maintaining safe GH levels, thus reducing  financial burden for the health care system.

Methods: We reviewed the records of 67 patients (34 m and 33 f) followed-up in our centre for acromegaly and treated with SSAs:  43 were on lanreotide (Somatuline Autogel) and 24 on octreotide (Sandostatin LAR). A mean growth hormone <2.5 microgs/l and normal IGF-1 levels were used to confirm control of the disease.

Results: 8 patients (11.9%) received 3-weekly injections, 40 patients (59%) 4-weekly, 9 patients (13.4%) 6-weekly, 8 patients (11.9%) 8-weekly and 2 patients (2.9%) every 12 weeks; 16 of the patients (23.8%) had received radiotherapy and are controlled on a 3- or 4-weekly regimen.  Seven patients (10.4%) on 3- or 4-weekly injections did not achieve safe growth hormone or IGF-1 levels. Amongst those on dose extension (19), all maintained safe mean GH levels. This translates to a reduction of approximately 119 injections per year leading to a substantial reduction in the cost of treatment [estimated approximately 95,000 GBP (150,000 USD) annually].

Conclusion: In our center, SSA administration can be safely reduced in at least 32% of patients with acromegaly beneficially affecting patient convenience and quality of life, as well as providing significant health cost savings. We therefore, recommend a trial of dose extension in all controlled acromegalics on SSA therapy as routine clinical practice.

Nothing to Disclose: VT, AV, NK, AG, JAHW

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm