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Lanreotide reduces the volume of polycystic liver: a randomized, double-blind, placebo-controlled trial
Loes van Keimpema1, Frederik Nevens, Ragna Vanslembrouck
1Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Background & Aims:
Therapy for polycystic liver is invasive, expensive, and has disappointing long-term results. Treatment with somatostatin analogues slowed kidney growth in patients with polycystic kidney disease (PKD) and reduced liver and kidney volume in a PKD rodent model. We evaluated the effects of lanreotide, a somatostatin analogue, in patients with polycystic liver because of autosomal-dominant (AD) PKD or autosomal-dominant polycystic liver disease (PCLD).
Methods:
We performed a randomized, double-blind, placebo-controlled trial in 2 tertiary referral centers. Patients with polycystic liver (n = 54) were randomly assigned to groups given lanreotide (120 mg) or placebo, administered every 28 days for 24 weeks. The primary end point was the difference in total liver volume, measured by computerized tomography at weeks 0 and 24. Analyses were performed on an intention-to-treat basis.
Results:
Baseline characteristics were comparable for both groups, except that more patients with ADPKD were assigned to the placebo group (P = .03). The mean liver volume decreased 2.9%, from 4606 mL (95% confidence interval (CI): 547-8665) to 4471 mL (95% CI: 542-8401 mL), in patients given lanreotide. In the placebo group, the mean liver volume increased 1.6%, from 4689 mL (95% CI: 613-8765 mL) to 4895 mL (95% CI: 739-9053 mL) (P < .01). Post hoc stratification for patients with ADPKD or PCLD revealed similar changes in liver volume, with statistically significant differences in patients given lanreotide (P < .01 for both diseases).
Conclusions:
In patients with polycystic liver, 6 months of treatment with lanreotide reduces liver volume.
Insights
Lanreotide treatment significantly reduced liver volume in patients with polycystic liver disease. This study shows potential for somatostatin analogues in managing polycystic liver conditions.
Area of Science:
- Hepatology
- Endocrinology
- Genetics
Background:
- Current therapies for polycystic liver are invasive and yield poor long-term outcomes.
- Somatostatin analogues have shown promise in slowing kidney growth in polycystic kidney disease (PKD) and reducing organ volume in animal models.
- This study investigates lanreotide for polycystic liver associated with autosomal-dominant (AD) PKD or autosomal-dominant polycystic liver disease (PCLD).
Purpose of the Study:
- To evaluate the efficacy of lanreotide in reducing liver volume in patients with polycystic liver.
- To compare the effects of lanreotide versus placebo over a 24-week period.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- Fifty-four patients with polycystic liver were randomized to receive either lanreotide (120 mg every 28 days) or a placebo for 24 weeks.
- Total liver volume was measured using computerized tomography at baseline and 24 weeks.
Main Results:
- Lanreotide treatment resulted in a 2.9% mean decrease in total liver volume.
- The placebo group experienced a 1.6% mean increase in liver volume.
- Significant reductions in liver volume were observed with lanreotide in both ADPKD and PCLD patient subgroups.
Conclusions:
- Six months of lanreotide treatment effectively reduces liver volume in patients suffering from polycystic liver.
- Lanreotide represents a promising therapeutic option for managing polycystic liver disease.
