This study aims to compare economic and patient impacts of the treatment of acromegaly with two different somatostatin analogues (octreotide LAR and lanreotide SR) in Brazil. A cost-effectiveness analysis was carried out under the Brazilian Public Health Care System (SUS) perspective. A decision analytical model was developed based on the Brazilian Public Health Care System Clinical Guideline for Acromegaly. A hypothetical cohort of 276 patients was followed for two years. Data were extracted from literature and administrative databases. Based on […]

Long-acting somatostatin analogs are often used for treating acromegaly, either as adjuvant to surgery or radiotherapy or, more recently, as a primary therapeutic option. These drugs seem to be reasonably safe, but new adverse effects not yet described may occur during the use of the relatively new long-acting formulations. In this case report, we describe a severe cutaneous reaction (erythema multiforme) in a patient treated with long-acting release (LAR) octreotide, and also discuss the need of previous “testing” with short […]

Cushing’s syndrome (CS) due to ectopic ACTH secretion has a high morbidity and mortality. Thus, rapid treatment of ectopic CS is mandatory. Carcinoid tumors associated with ectopic ACTH (CTu-ACTH) syndrome represent a more severe clinical picture, due to the carcinoid symptoms that worsen the hypercortisolism state. Management of patients with CTu-ACTH should include the control of hypercortisolism, as well as the carcinoid disturbance. We report 3 patients (2F, 1M) with CTu-ACTH (2 pancreatic, 1 ocult) who presented with clinical manifestations […]

This paper presents a clinical case of persistent hyperinsulinemic hypoglycemia of infancy (PHHI) and a literature review on this subject. We report on a newborn who presented with hypoglycemic episodes in her first 24hs of life and was treated successfully with octreotide until the moment. PHHI is the most common cause of persistent hyperinsulinism in infancy and can be hazardous for the development of the central nervous system. There are few current options for clinical treatment, with variable efficacy, and […]

Somatostatin analogues are frequently used to treat acromegaly. To determine the value of the acute test (AT) with subcutaneous (SC) octreotide as a predictor of the response to treatment with octreotide LAR®, we analyzed data from 20 patients. For the AT, blood was drawn before and two hours after the SC administration of octreotide for measuring GH. GH levels before and after the AT were 21.9ng/mL (2.3-143.4) and 3.1ng/mL (0.3-61.3), respectively. Control of the disease was defined as: GH< 2.5ng/mL […]

We evaluated GH, IGF-1 and IGFBP-3 concentrations in ten acromegalic patients before and after treatment with subcutaneous octreotide (OCT-sc) and long-acting octreotide (OCT-LAR). We also evaluated the acute and short-period treatment (post 21 days) with octreotide as an index to test tolerance and responsiveness to both formulations. Patients were also evaluated after 6 months of treatment with each drug. Pre-treatment fasting GH (µg/l; IFMA), GH nadir during oGTT and IGF-1 (µg/l; IRMA) levels were 13.9±6.3; 11.4±6.3; 717±107, respectively. Fasting GH […]