Treatment of thyroid-stimulating hormone-secreting adenomas with octreotide

From data collected in the literature, the effects of octreotide therapy in 37 patients with thyroid-stimulating hormone (TSH)-secreting adenomas who received short-term (1 to 2 weeks, n = 23) and long-term treatment (3 to 36 months) are reviewed. In 20 of 21 patients studied, short-term administration of octreotide (50 or 100 micrograms subcutaneously [SC] produced a 25% to 100% (mean +/- SD, 55.3% +/- 29%) decrease in TSH levels, with the nadir being obtained between the third and sixth hour following injection. After 1 to 2 weeks therapy with 50 to 100 micrograms twice or three times a day, 21 of 23 patients studied demonstrated a 66% (+/- 30%) decrease in TSH levels and 14 of 16 showed a 64% (+/- 27%) decrease in alpha-subunit levels. In approximately two thirds of the patients, the response was better than after short-term administration. The effect of octreotide on clinical and biological thyroid status was significant in all patients studied. After 1 week or 1 month of treatment, thyroid hormone levels were reduced in all patients and were normalized in 78%. Response to therapy was similar whether TSH secretion was pure or mixed (growth hormone [GH]-TSH adenomas). Fourteen patients received long-term treatment (3 to 36 months; mean, 12 +/- 10) with daily doses ranging from 200 to 1,500 micrograms. The response was better than or similar to that with short-term treatment. An escape occurred in TSH levels in two patients and in thyroid hormone levels in three patients, leading to an adjustment of dose or frequency of injection.(ABSTRACT TRUNCATED AT 250 WORDS)