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Newer parameters of the octreotide test in patients with acromegaly
Shin Urai1, Masaaki Yamamoto2, Naoki Yamamoto1
1Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Purpose:
Predicting the therapeutic effects of first-generation somatostatin receptor ligands (fg-SRLs) is important when assessing or planning effective treatment strategies in patients with acromegaly. The oft-used maximum growth hormone (GH) suppression rate parameter of the octreotide test has a suboptimal predictive value. Therefore, this study explored newer parameters of the octreotide test for predicting the therapeutic effect of long-acting fg-SRLs.
Methods:
In this single-center retrospective study, the octreotide test parameters and the therapeutic effects of fg-SRL at 3 months were investigated in 45 consecutive treatment-naïve patients with acromegaly between April 2008 and March 2023. Additionally, the relationship between the octreotide test parameters and the therapeutic effects of fg-SRLs was investigated. Tumor shrinkage was evaluated based on changes in the longitudinal diameter of the macroadenomas. The area GH suppression rate-time under the curve (AUC) and the time to nadir GH level were calculated and compared with the maximum GH suppression rate.
Results:
The AUC estimated reductions in serum insulin-like growth factor I, and tumor shrinkage. The time to nadir GH level predicted tumor shrinkage more robustly than the maximum GH suppression rate in patients with macroadenoma.
Conclusion:
The AUC and time to nadir GH level may potentially be newer parameters of the octreotide test for estimating the therapeutic effect of fg-SRLs.
Insights
Newer octreotide test parameters, including the area under the curve (AUC) and time to nadir growth hormone (GH) level, show promise for predicting treatment response to first-generation somatostatin receptor ligands (fg-SRLs) in acromegaly patients.
Area of Science:
- Endocrinology
- Oncology
- Pharmacology
Background:
- Acromegaly treatment relies on predicting therapeutic effects of first-generation somatostatin receptor ligands (fg-SRLs).
- The standard octreotide test's maximum growth hormone (GH) suppression rate has limited predictive value.
- Novel parameters are needed to optimize treatment strategies for acromegaly.
Purpose of the Study:
- To explore newer parameters of the octreotide test for predicting therapeutic effects of long-acting fg-SRLs in acromegaly.
- To compare the predictive value of novel octreotide test parameters against the maximum GH suppression rate.
Main Methods:
- Retrospective analysis of 45 treatment-naïve acromegaly patients.
- Investigated octreotide test parameters and fg-SRL therapeutic effects at 3 months.
- Calculated area under the curve (AUC) for GH suppression rate-time and time to nadir GH level; compared with maximum GH suppression rate.
Main Results:
- The AUC predicted reductions in insulin-like growth factor I and tumor shrinkage.
- Time to nadir GH level demonstrated a more robust prediction of tumor shrinkage in macroadenoma patients compared to maximum GH suppression rate.
Conclusions:
- Area under the curve (AUC) and time to nadir GH level show potential as improved predictors of fg-SRL therapeutic effects.
- These novel parameters may enhance treatment planning for acromegaly.
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