Abstract
The usefulness of the acute octreotide test in the selection of acromegalic patients
for chronic somatostatin depot analogues treatment is controversial. The aim of the
present study was to determine its accuracy for chronic response prediction, and the
reliability of a short version of the classic 6-hour test. The data from 26 acromegalics
(19 women, 7 men, mean age 52.6±13.1 years) studied with an acute octreotide test
(6 hours sampling for GH measurement after octreotide 100 μg s. c.) were retrospectively
analyzed. Eighteen of them followed chronic somatostatin depot analogues treatment
for 12 months. GH nadir was always detected at 2 hours (mean decrease 75.9±24%). GH
levels at 2 hours positively correlated with the other time-points (rs 0.97, 0.98, 0.97, 0.96 at 3, 4, 5 and 6 h, respectively; p<0.0001). During chronic
treatment with maximal effective dose for 12 months, 61% of the patients achieved
IGF1 <3 SD and 22% reached IGF1 <2 SD. GH nadir correlated with IGF1 decrease at 12
months (rs 0.76, p<0001). GH nadir of 9.2 ng/ml predicts IGF1 <3 SD with 82% sensitivity and
58% specificity (75% PPV, 67% NPV); for IGF1<2 SD, 75% sensitivity and 58% specificity
are obtained for GH nadir 3.6 ng/ml, with 33% PPV and 89% NPV. Acute octreotide test
reliably predicts response to long-term treatment; the short, 2-hour version is fully
informative for therapeutic decisions in acromegalic patients.
Key words
acromegaly - octreotide - drug treatment - pituitary tumors
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Correspondence
I. Halperin
Servei d'Endocrinologia
Hospital Clínic
Universitat de Barcelona
Villarroel 170
08036 Barcelona
Spain
Phone: +34/93/227 98 46
Fax: +34/93/451 66 38
Email: halperin@clinic.ub.es
