Efficacy of octreotide LAR and lanreotide autogel in acromegaly assessed by SAGIT
Main Article Content
Keywords
Acromegaly, Octreotid, Lanreotide, Insulin-Like Growth Factor I, SAGIT
Abstract
Abstract
Background: Biochemical control has been the main objective in the treatment of acromegaly; however, GH and IGF-1 levels do not necessarily translate into clinical response, as they fail to account for the complexity of symptoms and patients' perceptions. The SAGIT instrument was developed to assist in assessing the status and evolution of the disease in patients with acromegaly and facilitate decision-making.
Objective: To compare the efficacy of octreotide LAR and lanreotide autogel in managing patients with acromegaly using the SAGIT instrument.
Material and methods: Observational, unicentric study, conducted in 2022 at a referral hospital in León, Guanajuato, Mexico.
Results: Of 37 patients evaluated, 26 were included. 13 (50%) received lanreotide autogel and 11 (42.3%) received octreotide LAR. Disease control, as measured by IGF-1 levels, was achieved in 10 patients (42.3%). When assessing control using the SAGIT instrument, 8 patients (30.7%) met control criteria. Octreotide LAR showed greater disease control as assessed by SAGIT compared to lanreotide autogel (p = 0.043).
Conclusions: Based on the SAGIT instrument, octreotide LAR is more effective for disease control in patients with acromegaly than in those patients treated with lanreotide. The preferential use of octreotide LAR could be recommended in resource-limited settings.
References
1. Brue T, Rahabi H, Barry A, et al. Position statement on the diagnosis and management of acromegaly: The French National Diagnosis and Treatment Protocol (NDTP). Ann Endocrinol (Paris). 2023;84(6):697-710. doi: 10.1016/j.ando.2023.08.003
2. Varlamov EV, Niculescu DA, Banskota S, et al. Clinical features and complications of acromegaly at diagnosis are not all the same: data from two large referral centers. Endocr Connect. 2021;10(7):731-41. doi: 10.1530/EC-21-0035
3. Cadena-Obando DA, Remba-Shapiro I, Abreu-Rosario CG, et al. Acromegalia y sus implicaciones cardiovasculares. Rev Med Inst Mex Seguro Soc. 2021;59(1):73-80. doi: 10.24875/RMIMSS.M21000054
4. Laszczak K, Niedobylski S, Warchoł K, et al. Prevalence, incidence, and risk of cancers in patients with acromegaly: review. J Educ Health Sport. 2022;12(6):11-25. doi: 10.12775/jehs.2022.12.06.001
5. Rolla M, Jawiarczyk-Przybyłowska A, Halupczok-Żyła J, et al. Complications and Comorbidities of Acromegaly-Retrospective Study in Polish Center. Front Endocrinol (Lausanne). 2021;12:642131. doi: 10.3389/fendo.2021.642131
6. Melgar V, Espinosa E, Cuenca D, et al. Diagnóstico y tratamiento actual de la acromegalia. Rev Med Inst Mex Seguro Soc. 2015;53(1):74-83.
7. Fleseriu M, Biller BMK, Freda PU, et al. A Pituitary Society update to acromegaly management guidelines. Pituitary. 2021;24(1):1-13. doi: 10.1007/s11102-020-01091-7
8. Ershadinia N, Tritos NA. Diagnosis and Treatment of Acromegaly: An Update. Mayo Clin Proc. 2022;97(2):333-46. doi: 10.1016/j.mayocp.2021.11.007
9. Clemmons DR, Bidlingmaier M. Interpreting growth hormone and IGF-I results using modern assays and reference ranges for the monitoring of treatment effectiveness in acromegaly. Front Endocrinol (Lausanne). 2023;14:1266339. doi: 10.3389/fendo.2023.1266339
10. Cardoso LM, Marques P, Pereira MT, et al. Diagnosis and Management of Acromegaly: A Consensus Statement of the Pituitary Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism. Endocrinol Insights. 2025 Apr;20(1):29-58. doi: 10.1159/000541671
11. Bray DP, Mannam S, Rindler RS, et al. Surgery for acromegaly: Indications and goals. Front Endocrinol (Lausanne). 2022;13:924589. doi: 10.3389/fendo.2022.924589
12. Giustina A, Barkhoudarian G, Beckers A, et al. Multidisciplinary management of acromegaly: A consensus. Rev Endocr Metab Disord. 2020;21(4):667-78. doi: 10.1007/s11154-020-09588-z
13. Giustina A, Biermasz N, Casanueva FF, et al. Acromegaly Consensus Group. Consensus on criteria for acromegaly diagnosis and remission. Pituitary. 2024;27(1):7-22. doi: 10.1007/s11102-023-01360-1
14. Dassie F, Ceccato F, Sartorato P, et al. ACRODAT and SAGIT for the assessment of disease activity in acromegaly: a multicenter study of the Veneto region in Italy. Pituitary. 2025;28(4):76. doi: 10.1007/s11102-025-01543-y
15. Giustina A, Bronstein MD, Chanson P, et al. International Multicenter Validation Study of the SAGIT® Instrument in Acromegaly. J Clin Endocrinol Metab. 2021;106(12):3555-68. doi: 10.1210/clinem/dgab536
16. Sawicka-Gutaj N, Ziółkowska P, Biczysko A, et al. The potential utility of the SAGIT instrument in the clinical assessment of patients with acromegaly, a large single-centre study. Sci Rep. 2023;13(1):3286. doi: 10.1038/s41598-023-29957-3
17. Guinto G, Guinto-Nishimura GY, Uribe-Pacheco R, et al. Surgical outcomes in patients with acromegaly: Microscopic vs. endoscopic transsphenoidal surgery. Best Pract Res Clin Endocrinol Metab. 2024;38(4):101879. doi: 10.1016/j.beem.2024.101879
18. Fleseriu M, Langlois F, Lim DST, et al. Acromegaly: pathogenesis, diagnosis, and management. Lancet Diabetes Endocrinol. 2022;10(11):804-26. doi: 10.1016/S2213-8587(22)00244-3
19. Corica G, Ceraudo M, Campana C, et al. Octreotide-Resistant Acromegaly: Challenges and Solutions. Ther Clin Risk Manag. 2020;16:379-391. doi: 10.2147/TCRM.S183360
20. Ogedegbe OJ, Cheema AY, Khan MA,et al. Comprehensive Review of Four Clinical Practice Guidelines of Acromegaly. Cureus. 2022;14(9):e28722. doi: 10.7759/cureus.28722
21. Ershadinia N, Tritos NA. Diagnosis and Treatment of Acromegaly: An Update. Mayo Clin Proc. 2022;97(2):333-46. doi: 10.1016/j.mayocp.2021.11.007
22. Singh R, Didwania P, Lehrer EJ, et al. Stereotactic radiosurgery for acromegaly: an international systematic review and meta-analysis of clinical outcomes. J Neurooncol. 2020;148(3):401-18. doi: 10.1007/s11060-020-03552-2
23. Albano L, Losa M, Garbin E, et al. Efficacy and safety of radiosurgery in acromegaly. Best Pract Res Clin Endocrinol Metab. 2024;38(4):101898. doi: 10.1016/j.beem.2024.101898
24. Remba-Shapiro I, Nachtigall LB. Treatment of acromegaly with oral octreotide. Best Pract Res Clin Endocrinol Metab. 2024;38(4):101888. doi: 10.1016/j.beem.2024.101888
25. Soukup J, Hornychova H, Manethova M, et al. Predictive and prognostic significance of tumour subtype, SSTR1-5 and e-cadherin expression in a well-defined cohort of patients with acromegaly. J Cell Mol Med. 2021;25(5):2484-92. doi: 10.1111/jcmm.16173
26. Wildemberg LE, Fialho C, Gadelha MR. Treatment of acromegaly with the nonpeptide, highly selective somatostatin receptor type 2 agonist paltusotine. Best Pract Res Clin Endocrinol Metab. 2024;38(4):101906. doi: 10.1016/j.beem.2024.101906
27. Gadelha MR, Gadelha AC, Kasuki L. New Treatments for Acromegaly in Development. J Clin Endocrinol Metab. 2024;109(4):e1323-7. doi: 10.1210/clinem/dgad568
28. Camerini S, Wennberg A, Adriani M, et al. Questionnaire and tools: clinical powerful instrument in acromegaly diagnosis and management. J Endocrinol Invest. 2022;45(10):1823-34. doi: 10.1007/s40618-022-01782-x
29. Herman R, Goričar K, Janež A, et al. Clinical Applicability of Patient- and Clinician-Reported Outcome Tools in the Management of Patients With Acromegaly. Endocr Pract. 2022;28(7):678-83. doi: 10.1016/j.eprac.2022.04.002
30. Giustina A, Bevan JS, Bronstein MD, et al. SAGIT Investigator Group. SAGIT®: clinician-reported outcome instrument for managing acromegaly in clinical practice--development and results from a pilot study. Pituitary. 2016;19(1):39-49. doi: 10.1007/s11102-015-0681-2
31. Alfonso-Cristancho R, Herran Diazgranados S, Maestre Martinez K, et al. Cost-effectiveness of somatostatin analogues for the treatment of acromegaly in Colombia. OJEMD. 2012;2(4):102-6. doi: 10.4236/ojemd.2012.24016
32. Valentim J, Passos V, Mataveli F, et al. Cost-effectiveness analysis of somatostatin analogues in the treatment of acromegaly in Brazil. Arq Bras Endocrinol Metabol. 2008;52(9):1452-60. doi: 10.1590/s0004-27302008000900008
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