Lanreotide autogel in acromegaly - a decade on

Expert Opin Pharmacother. 2014 Dec;15(18):2681-92. doi: 10.1517/14656566.2014.970173. Epub 2014 Oct 11.

Abstract

Introduction: The novel formulation of lanreotide, lanreotide (LAN) autogel (ATG), has been available in Europe since 2001 and USA from 2006 for the treatment of acromegaly. It is one of only two clinically available somatostatin analogs available for use in acromegaly. Data relating to the use of ATG in acromegaly, specifically relating to comparison to octreotide (OCT) LAR and patient acceptability and preference, have been slow to accumulate.

Areas covered: We performed a comprehensive review of the original literature relating to development, pharmacokinetics, acceptability and clinical efficacy of ATG.

Expert opinion: LAN ATG is a novel formulation of LAN consequent on self-assembly of nanotubules in water. Diffusion between molecules within the nanotubules and surrounding tissue fluid in vivo leads to pseudo first-order pharmacokinetics. Efficacy is equivalent to the alternate long-acting somatostatin analog, OCT LAR, normalizing growth hormone and IGF-I levels in around 60 and 50% respectively. Control of tumor growth is observed in over 95% of patients, with 64% seeing a clinically significant reduction in tumor size. ATG is provided in a prefilled syringe for deep subcutaneous injection, allowing self-injection, and may be administered up to 8 weeks greatly improving convenience for the patient. The data strongly support consideration of ATG as the medical therapy of choice for patients with acromegaly.

Keywords: IGF; acromegaly; growth hormone; lanreotide; octreotide; somatostatin analogs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acromegaly / drug therapy*
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use*
  • Half-Life
  • Human Growth Hormone / metabolism
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Peptides, Cyclic / pharmacokinetics
  • Peptides, Cyclic / therapeutic use*
  • Somatostatin / analogs & derivatives*
  • Somatostatin / pharmacokinetics
  • Somatostatin / therapeutic use

Substances

  • Antineoplastic Agents
  • Peptides, Cyclic
  • lanreotide
  • Human Growth Hormone
  • Somatostatin
  • Insulin-Like Growth Factor I