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Pituitary
Published in: Pituitary 3/2016

Open Access 01-06-2016

Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly

Authors: Annamaria Colao, Renata S. Auriemma, Rosario Pivonello, Leandro Kasuki, Mônica R. Gadelha

Published in: Pituitary | Issue 3/2016

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Abstract

Context

The somatostatin analogues octreotide LAR and lanreotide Autogel have been evaluated for the treatment of acromegaly in numerous clinical trials, with considerable heterogeneity in reported biochemical response rates. This review examines and attempts to account for these differences in response rates reported in the literature.

Evidence acquisition

PubMed was searched for English-language studies of a minimum duration of 24 weeks that evaluated ≥10 patients with acromegaly treated with octreotide LAR or lanreotide Autogel from 1990 to March 2015 and reported GH and/or IGF-1 data as the primary objective of the study.

Evidence synthesis

Of the 190 clinical trials found, 18 octreotide LAR and 15 lanreotide Autogel studies fulfilled the criteria for analysis. It is evident from the protocols of these studies that multiple factors are capable of impacting on reported response rates. Prospective studies reporting an intention-to-treat analysis that evaluated medically naïve patients and used the composite endpoint of both GH and IGF-1 control were associated with lower response rates. The use of non-composite biochemical control endpoints, heterogeneous patient populations, analyses that exclude treatment non-responders, assay variability and prior responsiveness to medical therapy are just a few of the factors identified that likely contribute to higher success rates.

Conclusions

The wide range of reported response rates with somatostatin analogues may be confusing and could lead to misinterpretation by both the patient and the physician in certain situations. Understanding the factors that potentially drive the variation in response rates should allow clinicians to better gauge treatment expectations in specific patients.
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Metadata
Title
Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly
Authors
Annamaria Colao
Renata S. Auriemma
Rosario Pivonello
Leandro Kasuki
Mônica R. Gadelha
Publication date
01-06-2016
Publisher
Springer US
Published in
Pituitary / Issue 3/2016
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-015-0684-z

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