Magazine article Drug Topics

Long-Acting Preparation Approved for Acromegaly

Magazine article Drug Topics

Long-Acting Preparation Approved for Acromegaly

Article excerpt

While Andre the Giant may have been considered the reigning predator by his opponents in the wrestling ring, he was actually a victim of the very ailment that made him the gargantuan star we all knew.

In great company with a few other larger-than-life people, the late Andre suffered from acromegaly-a disfiguring hormonal disorder caused by excessive secretion of growth hormone (GH) from a pituitary tumor. Raging GH levels produce the characteristic signs of acromegaly, which may include a coarsening of facial features and an enlargement of the hands, feet, tongue, and internal organs.

Treatment options include surgery to remove the offending tumor and/or radiation to shrink it. Pharmacologic management, is centered around the use of the GH inhibitor octreotide and, less often, bromocriptine. Patients would typically endure the tedious process of having to inject themselves subcutaneously (SQ) with octreotide three times a day-that is, until now. Just recently, Novartis' long-acting preparationSandostatin LAR Depot (octreotide acetate for injectable suspension was approved for use in acromegaly patients who have responded to and tolerated SQ injections of octreotide. The product is also indicated for long-term treatment of those with carcinoid tumors and vasoactive intestinal peptide tumors (vipomas).

Sandostatin LAR, which must be injected intragluteally every four weeks, consists of glucose polymer microspheres that contain octreotide. As the polymer biodegrades-a process that is primarily accomplished through hydrolysis-the actual drug is slowly released into circulation, noted Wanda Toro, Pharm.D., Novartis brand manager.

According to Shlomo Melmed, M.D., v.p. of academic affairs at Cedars-Sinai Medical Center, Sandostatin LAR maintains all of the clinical and pharmacological characteristics of the immediate-release formulation-"producing very efficacious levels throughout the month."

So how does octreotide take control of acromegaly? The drug's pharmacologic properties are known to mimic those of the natural hormone somatostatin. And like somatostatin, octreotide exerts a variety of actions, among which are inhibition of GH and IGF-1 (insulin-like growth factor) levels and suppression of the luteinizing hormone's response to gonadotropin-releasing hormone (GnRH). …

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