Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Somatuline LA (Ipsen)
glass vials containing 40 mg as powder (only 30 mg is available for the patient due to losses of the active ingredient during sterilisation, resuspension and administration)
Approved indication: acromegaly
Australian Medicines Handbook Section 10.6.4
Somatostatin is a peptide which inhibits the secretion of growth hormone. Synthetic analogues of somatostatin, such as octreotide and lanreotide, can therefore be used in the treatment of acromegaly which results from an excessive concentration of growth hormone.
Lanreotide is indicated for patients whose concentrations of growth hormone remain high despite surgery and/or radiotherapy. It is also indicated for patients who are refractory to treatment with a dopamine agonist.
A modified-release formulation allows lanreotide to be initially given every14 days. After reconstitution it is injected intramuscularly. There is a rapid release, followed by a prolonged release from the micro particles in the formulation. The half-life of this formulation is approximately five days. Although the product is injected its bioavailability is 57%.
A European study involving 125 patients compared injections of 30 mg lanreotide every 10-14 days with monthly injections of 20 mg of modified-release octreotide. The growth hormone concentration was reduced significantly more by octreotide than by lanreotide and more patients reached the target concentrations.1
The most frequent adverse effects of lanreotide are reactions at the injection site and gastrointestinal upsets. As lanreotide may reduce gall bladder motility, patients should have an ultrasound scan before treatment and every six months during treatment.
Although more than half the patients treated with lanreotide will respond satisfactorily, some need injections more frequently than every 14 days. Lanreotide may be less effective than octreotide.
- Chanson P, Boerlin V, Ajzenberg C, Bachelot Y, Benito P, Bringer J, et al. Comparison of octreotideacetate LAR and lanreotide SR in patients with acromegaly. Clin Endocrinol2000;53:577-86.