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Long-term treatment of acromegaly with Sandostatin (SMS 201-995). Normalization of most anomalous growth hormone responses.

Abstract

Twelve patients with active acromegaly were treated with the long-acting somatostatin analogue SMS 201-995 (SMS), at a dose of 50 micrograms sc twice daily in the first 2 weeks of treatment and 100 micrograms sc thereafter. Four h after the first injection of SMS, GH levels became normal in 8 of the 12 patients. Basal glucose levels were significantly lower at the 28th day of treatment. This glucose lowering effect was stronger in the diabetic than in the nondiabetic patients. The postprandial rise of insulin levels was reversed by SMS, leading to a more pronounced postprandial rise of glucose, whereas the postprandial secretion of glucagon was also reversed by SMS. The rise of glucose levels during oral glucose loading was similar before and during SMS, despite a strong inhibitory effect of the drug on the insulin rise after glucose loading. Basal TSH levels were not influenced by SMS, the TRH-induced TSH response, however, was significantly blunted. Although the basal PRL levels were significantly reduced by SMS, the TRH-induced PRL rise was similar before and during administration of the analogue. Paradoxical GH responses to TRH disappeared in 7 out of 8 patients during SMS. Paradoxical GH responses to GnRH, however, persisted in 4 out of 4 patients. Paradoxical responses of GH after glucose loading disappeared in 2 out of 2 patients. The GH response after GHRH administration was strongly suppressed by SMS. During long-term treatment (up to 2 years), the GH level obtained within 5 h after the last injection of SMS remained normal in the patients whose GH levels normalized at the first day of treatment. There was a good response of the disease to this treatment, and no serious adverse reactions were observed. We conclude that SMS normalizes most anomalous growth hormone kinetics in acromegaly. The drug offers a new tool in the treatment of this disease.

Authors+Show Affiliations

Department of Medicine, St. Radboud Hospital, University of Nijmegen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2892339

Citation

Pieters, G F., et al. "Long-term Treatment of Acromegaly With Sandostatin (SMS 201-995). Normalization of Most Anomalous Growth Hormone Responses." Acta Endocrinologica. Supplementum, vol. 286, 1987, pp. 9-18.
Pieters GF, van Liessum PA, Smals AG, et al. Long-term treatment of acromegaly with Sandostatin (SMS 201-995). Normalization of most anomalous growth hormone responses. Acta Endocrinol Suppl (Copenh). 1987;286:9-18.
Pieters, G. F., van Liessum, P. A., Smals, A. G., van Gennep, J. A., Benraad, T. J., & Kloppenborg, P. W. (1987). Long-term treatment of acromegaly with Sandostatin (SMS 201-995). Normalization of most anomalous growth hormone responses. Acta Endocrinologica. Supplementum, 286, 9-18.
Pieters GF, et al. Long-term Treatment of Acromegaly With Sandostatin (SMS 201-995). Normalization of Most Anomalous Growth Hormone Responses. Acta Endocrinol Suppl (Copenh). 1987;286:9-18. PubMed PMID: 2892339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term treatment of acromegaly with Sandostatin (SMS 201-995). Normalization of most anomalous growth hormone responses. AU - Pieters,G F, AU - van Liessum,P A, AU - Smals,A G, AU - van Gennep,J A, AU - Benraad,T J, AU - Kloppenborg,P W, PY - 1987/1/1/pubmed PY - 1987/1/1/medline PY - 1987/1/1/entrez SP - 9 EP - 18 JF - Acta endocrinologica. Supplementum JO - Acta Endocrinol Suppl (Copenh) VL - 286 N2 - Twelve patients with active acromegaly were treated with the long-acting somatostatin analogue SMS 201-995 (SMS), at a dose of 50 micrograms sc twice daily in the first 2 weeks of treatment and 100 micrograms sc thereafter. Four h after the first injection of SMS, GH levels became normal in 8 of the 12 patients. Basal glucose levels were significantly lower at the 28th day of treatment. This glucose lowering effect was stronger in the diabetic than in the nondiabetic patients. The postprandial rise of insulin levels was reversed by SMS, leading to a more pronounced postprandial rise of glucose, whereas the postprandial secretion of glucagon was also reversed by SMS. The rise of glucose levels during oral glucose loading was similar before and during SMS, despite a strong inhibitory effect of the drug on the insulin rise after glucose loading. Basal TSH levels were not influenced by SMS, the TRH-induced TSH response, however, was significantly blunted. Although the basal PRL levels were significantly reduced by SMS, the TRH-induced PRL rise was similar before and during administration of the analogue. Paradoxical GH responses to TRH disappeared in 7 out of 8 patients during SMS. Paradoxical GH responses to GnRH, however, persisted in 4 out of 4 patients. Paradoxical responses of GH after glucose loading disappeared in 2 out of 2 patients. The GH response after GHRH administration was strongly suppressed by SMS. During long-term treatment (up to 2 years), the GH level obtained within 5 h after the last injection of SMS remained normal in the patients whose GH levels normalized at the first day of treatment. There was a good response of the disease to this treatment, and no serious adverse reactions were observed. We conclude that SMS normalizes most anomalous growth hormone kinetics in acromegaly. The drug offers a new tool in the treatment of this disease. SN - 0300-9750 UR - https://www.unboundmedicine.com/medline/citation/2892339/Long_term_treatment_of_acromegaly_with_Sandostatin__SMS_201_995___Normalization_of_most_anomalous_growth_hormone_responses_ L2 - https://www.diseaseinfosearch.org/result/162 DB - PRIME DP - Unbound Medicine ER -