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Pasireotide superior to octreotide for biochemical control in acromegaly
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Patients with acromegaly who took long-acting pasireotide obtained better biochemical control than those who took long-acting octreotide, recent prospective data suggest.
Many patients with acromegaly do not typically demonstrate biochemical control, according to Annamaria Colao, MD, researcher and professor of endocrinology, chief of the neuroendocrine unit in the department of molecular and clinical endocrinology and oncology, Federico II University of Naples, Italy, and colleagues.
Medically naive patients with acromegaly across 84 sites and 27 countries were randomly assigned to either pasireotide long-acting release (LAR) 40 mg (SOM230, Novartis; n=176) or octreotide LAR 20 mg injectable (Sandostatin, Novartis; n=182) for 12 months.
The patients were titrated to pasireotide LAR 60 mg or octreotide LAR 30 mg at 3 and 7 months if growth hormone fell below 2.5 mcg/L, and/or in patients whose insulin-like growth factor I was below the lower normal limit, according to researchers.
“This study confirms that pasireotide LAR achieves greater suppression of IGF-I than octreotide LAR and is significantly superior to octreotide LAR at providing biochemical control,” researchers wrote.
Biochemical control was observed in significantly more patients assigned to pasireotide LAR (31.3%) vs. those assigned to octreotide LAR (19.2%; P=.007). Adjustments for patients with an IGF-I below the lower normal limit increased the biochemical control observed in patients assigned to pasireotide LAR (35.8%) vs. patients assigned to octreotide LAR (20.9%), according to data.
After 12 months, 38.6% patients assigned to pasireotide LAR and 23.6% patients assigned to octreotide LAR demonstrated normal IGF-I (P=.002). In addition, 48.3% of those assigned to pasireotide LAR and 51.6% assigned to octreotide LAR displayed GH <2.5 mcg/L, researchers wrote.
“Significantly more pasireotide LAR patients achieved biochemical control at month 12 than octreotide LAR patients (31.3% vs. 19.2% [P=.007]), with pasireotide LAR patients being 63% more likely to achieve biochemical control than octreotide LAR patients,” researchers wrote.
The most common adverse event was hyperglycemia-related and mostly reported in patients assigned to pasireotide LAR (57.3%) compared with octreotide (21.7%).
Disclosure: Several researchers report financial ties with Chiasma, Ipsen, Novartis and Pfizer.
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