Abstract
GH secretion in acromegaly was studied in 8 patients before and during treatment with SMS 201–995, a somatostatin analogue, 100 μg twice daily, by evaluating GH day profiles and GH suppressibility after oral glucose tolerance tests (OGTT). Normalization of GH secretion, estimated by OGTT, was only observed in the three patients who had a decrease in plasma GH to less than 2 μg/l after SMS 201–995 injection, and who had the lowest mean plasma GH levels during the day and the largest percent decline of mean plasma GH levels. We conclude that real normalization of GH secretion during SMS 201–995 therapy only occurs in a subset of patients. The data illustrate that the applicability of the generally held cut-off value of 5 μg/l, between normal and abnormal plasma GH, has to be reconsidered in the case of chronic intermittent subcutaneous therapy with SMS 201–995.
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Bauer W., Briner U., Doepfner W., Haller R., Huguenin R., Marbach P., Petcher T.J., Pless J. SMS 201–995: A very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci. 31: 1133, 1982.
Plewe G., Beyer J., Krause U., Neufeld M., Del Pozo E. Long-acting and selective suppression of growth hormone secretion by somatostatin analogue SMS 201–995 in acromegaly. Lancet 2: 782, 1984.
Lamberts S.W.J., Oosterom R., Neufeld M., Del Pozo E. The somatostatin analog SMS 201–995 induces longacting inhibition of growth hormone secretion without rebound hypersecretion in acromegalic patients. J. Clin. Endocrinol. Metab. 60: 1161, 1985.
Ch’ng L.J.C., Sandier L.M., Kraenzlin M.E., Burin J.M., Jopin C.F., Bloom S.R. Long term treatment of acromegaly with a long acting analogue of somatostatin. Br. Med. J. 290: 285, 1985.
Lamberts S.W.J., Uitterlinden P., Del Pozo E. SMS 201–995 induces a continuous decline in circulating growth hormone and somatomedin-C levels during therapy of acromegalic patients for over two years. J. Clin. Endocrinol. Metab. 65: 703, 1987.
Pieters G.F.F.M., Smals A.G.H., Kloppenborg P.W.C. Long-term treatment of acromegaly with the somatostatin analogue SMS 201–995. N. Engl. J. Med. 314: 1391, 1986 (Letter).
Schuster L.D., Bautle J.P., Oppenheimer J.H., Seljeskog E.L. Acromegaly: reassessment of the long-term therapeutic effectiveness of transsphenoidal pituitary surgery. Ann. Intern. Med. 95: 172, 1981.
Nortier J.W.R., Croughs R.J.M., Thijssen J.H.H., Schwarz F. Plasma growth hormone suppressive effect of bromocriptine in acromegaly. Evaluation by plasma GH day profiles and plasma GH concentrations during oral glucose tolerance tests. Clin. Endocrinol. (Oxf.) 20: 565, 1984.
Smals A.E.M., Pieters G.F.F.M., Smals A.G.H., Benraad Th.J., van Laarhoven J., Kloppenborg P.W.C. Sex difference in human growth hormone (GH) response to intravenous human pancreatic GH-releasing hormone administration in young adults. J. Clin. Endocrinol. Metab. 62: 336, 1986.
Lamberts S.W.J., Uitterlinden P., Verschoor L., van Dongen K.J., Del Pozo E. Long-term treatment of acromegaly with the somatostatin analogue SMS 201–995. N. Engl. J. Med. 313: 1576, 1985.
Clemmons D.R., van Wyk J.J., Ridgway E.C., Kliman B., Kjellberg R.N., Underwood L.E. Evaluation of acromegaly by radioimmunoassay of somatomedin-C. N. Engl. J. Med. 301: 1138, 1979.
Wass J.A.H., Clemmons D.R., Underwood L.E., Barrow I., Besser G.M., van Wyk J.J. Changes in circulating somatomedin-C levels in bromocriptine-treated acromegaly. Clin. Endocrinol. (Oxf.) 17: 369, 1982.
Daughaday W.H. New criteria for evaluation of acromegaly. N. Engl. J. Med. 301: 1175, 1979.
Nortier J.W.R., Croughs R.J.M., Thijssen J.H.H., Schwarz F. Bromocriptine therapy in acromegaly: effects on plasma GH levels, somatomedin-C levels and clinical activity. Clin. Endocrinol. (Oxf.) 22: 209, 1985.
Lamberts S.W.J., Uitterlinden P., Schuijff P.C., Klijn J.G.M. Therapy of acromegaly with sandostatin: the predictive value of an acute test, the value of serum somatomedin-C measurements in dose adjustment and the definition of a biochemical “cure”. Clin. Endocrinol. (Oxf.) 29: 411, 1988.
Oyen W.J.G., Pieters G.F.F.M., Meijer E., van Laarhoven J., Smals A.G.H., Kloppenborg P.W.C. Which factors predict the results of pituitary surgery in acromegaly? Acta Endocrinol. (Copenh.) 117: 491 1988.
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van Liessum, P.A., Pieters, G.F.F.M., Smals, A.G.H. et al. Does SMS 201–995 normalize growth hormone secretion in acromegaly? GH day profiles and GH concentrations after oral glucose loading. J Endocrinol Invest 12, 553–557 (1989). https://doi.org/10.1007/BF03350758
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DOI: https://doi.org/10.1007/BF03350758