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| ORIGINAL ARTICLE |
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| Year : 2010 | Volume
: 56
| Issue : 1 | Page : 7-11 |
The value of an acute octreotide suppression test in predicting response to long-term somatostatin analogue therapy in patients with acromegaly
TR Bandgar, V Sarathi, V Shivane, N Bansode, PS Menon, NS Shah
Department of Endocrinology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai-400 012, India
Correspondence Address:
T R Bandgar
Department of Endocrinology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai-400 012
India
 Source of Support: Sun Pharmaceuticals Industries Private Limited provided Octreotide-LAR,, Conflict of Interest: None  | Check |
DOI: 10.4103/0022-3859.62421
Context: The usefulness of the acute octreotide test in the selection of patients with acromegaly for chronic somatostatin depot analogues treatment is controversial. Aims: To determine the efficacy of acute octreotide suppression test (OST) in predicting response to long-term somatostatin analogue (Octreotide-long-acting repeatable, OCT-LAR) therapy in patients with acromegaly. Settings and Design: Prospective study (2006-2007) conducted at a tertiary healthcare centre in western India. Materials and Methods: Sixteen drug-naive patients with active acromegaly (postoperative±post radiotherapy) underwent 50 µg subcutaneous OST. Ten patients were treated with OCT-LAR for one year. Remission was defined as a nadir growth hormone (GH) <1 ng/ml during 75 g oral glucose tolerance test (OGTT) (0, 10, 30, 60, 120, 180 min) and normal age, sex-matched insulin-like growth factor 1 (IGF1) levels. Statistical Analysis: SPSS Software Version 11 was used for data analysis. Results: Using GH cutoff <1 ng/ml, four patients (40%) achieved control at 12 months, while five patients (50%) achieved normal IGF1 values. The mean basal GH levels in 10 responsive, four controlled and six uncontrolled patients were 34.7±61.14, 4.5±1.3 and 54.8±74.2 ng/ml respectively which suppressed to mean nadir GH of 3.75±4.03, 0.66±0.15 and 5.8±4 ng/ml respectively. Sensitivity, specificity, negative and positive predictive value for nadir GH <1 ng/ml reached after an OST was 100% each in predicting remission in our cohort. Odds for control increased if the baseline GH was low (<5 ng/ml in our cases). Conclusions: Nadir GH <1 ng/ml following an OST is a useful predictive marker of achieving disease remission with long-term OCT-LAR therapy.
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