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Optimalization and cost management of lanreotide-Autogel therapy in acromegaly

机译：肢端肥大症中兰瑞肽-Autogel治疗的优化和费用管理

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Background: Lanreotide-Autogel is a depot formulation of the somatostatin analog lanreotide used in the treatment of acromegaly. We investigated whether prolonging or shortening the interval between injections would offer any benefit. Subjects and methods: The interval was prolonged from once every 4 weeks to once every 6 weeks when patients (n = 9) had normal IGF-I and GH concentrations. When patients (n = 12) had still elevated IGF-I or GH on the maximal dose of 1.20 mg every 4 weeks, the interval was shortened to once every 3 weeks. Serum IGF-I and GH were measured after 12 and 24 weeks to allow for dose adaptation. Symptoms and tumor volume were evaluated at baseline and after 36 weeks. Results: In seven of the nine subjects with normal IGF-I and GH, the interval could be extended to 6 weeks without loosing efficacy on IGF-I (195 vs 213 mu g/l; not significant, NS) and GH concentrations (1.4 vs 1.3 mu g/l; NS). The weekly dose could significantly be reduced (from 23.3 to 17.8 mg; P=0.002). In only 1 of the 12 not-controlled patients, reducing the interval to once every 3 weeks induced normalization of IGF-I and GH. Conclusion: In subjects whose acromegaly is well controlled using lanreotide-Autogel, prolonging the time interval between injections can often be increased 4 to 6 weeks without loss of efficacy, thereby improving the subject's comfort and reducing the cost of treatment. On the other hand, in subjects whose acromegaly is not controlled on a dose of 120 mg every 4 weeks, reducing the interval to every 3 weeks is rarely beneficial.
机译：背景：Lanreotide-Autogel是生长抑素类似物Lanreotide的贮库制剂，用于肢端肥大症的治疗。我们调查了延长或缩短注射间隔会带来任何好处。对象和方法：当患者（n = 9）的IGF-I和GH浓度正常时，间隔从每4周一次延长到每6周一次。当患者（n = 12）仍以每4周1.20 mg的最大剂量升高IGF-I或GH时，间隔时间缩短为每3周一次。在12和24周后测量血清IGF-1和GH以适应剂量。在基线和36周后评估症状和肿瘤体积。结果：在IGF-I和GH正常的9名受试者中，有7名的时间间隔可以延长至6周，而对IGF-I（195 vs 213μg / l； NS并不显着）和GH浓度（1.4）没有疗效vs1.3μg/ l； NS）。每周剂量可以显着降低（从23.3降至17.8 mg； P = 0.002）。在12名不受控制的患者中，只有1名将间隔降低至每3周一次，即可诱导IGF-I和GH正常化。结论：在使用兰瑞肽-Autogel很好地控制了肢端肥大症的受试者中，延长注射间隔时间通常可以增加4至6周，而不会降低疗效，从而改善受试者的舒适度并降低治疗成本。另一方面，在肢端肥大症不受每4周120 mg剂量控制的受试者中，将间隔时间缩短至每3周几乎没有好处。

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