Ultrasound Guided Octreotide LAR Injection in Acromegaly

Overview

Approximately half of patients with acromegaly do not respond to treatment with somatostatin receptor ligands such as octreotide LAR. This may be due to inadequate drug delivery if the standard of care regular injection is inaccurately delivered in the intramuscular (IM) compartment. Ultrasound guidance of IM injections may improve accuracy of placement of IM injections and increase drug levels, thereby improving efficacy of octreotide LAR for the treatment of acromegaly. The purpose of this study is to determine whether octreotide LAR drug levels differ if given by ultrasound-guided IM injection or by regular IM injection in patients with acromegaly.

Full Title of Study: “Study to Determine Whether Ultrasound Guidance Improves Delivery and Efficacy of Intramuscular Injection of Long-Acting Octreotide in the Treatment of Acromegaly”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: March 2014

Interventions

  • Drug: Octreotide LAR 30 MG Injection
    • Stable dose of 30 mg octreotide LAR, or a dose determined by historical dosing, delivered every 28 days for 3 months.

Arms, Groups and Cohorts

  • Experimental: Ultrasound-guided IM injections of octreotide LAR
    • Subjects received octreotide LAR 30 mg injection via ultrasound-guided IM gluteal injection every 28 days for 3 months.
  • Active Comparator: Regular IM injections of octreotide LAR
    • Subjects received octreotide LAR 30 mg injection via regular IM gluteal injections every 28 days for 3 months

Clinical Trial Outcome Measures

Primary Measures

  • Plasma Octreotide Level After Each Treatment Phase
    • Time Frame: 3 months
    • Venous sampling was performed at each visit immediately prior to each IM injection. Levels were measured at each visit and mean for the group was calculated after each treatment phase.

Secondary Measures

  • Serum IGF-1 Level
    • Time Frame: 3 months
    • Venous sampling was performed at each visit immediately prior to each IM injection. Levels were measured at each visit and mean for the group was calculated after each treatment phase.

Participating in This Clinical Trial

Inclusion Criteria

  • Diagnosis of active acromegaly based on evidence of a pituitary tumor – Historical serum insulin-like growth factor (IGF)-I levels or a lack of suppression of growth hormone (GH) < 1 ng/mL during an oral glucose tolerance test – Previous treatment with a stable dose of octreotide LAR for at least 3 months – No previous treatment with a stable dose of octreotide LAR for at least 3 months after receiving 3 months of octreotide LAR during a run-in phase prior to any other study-related activity Exclusion Criteria:

  • Uncontrolled diabetes mellitus – Pregnant or breast feeding – Current gallstones – History of hepatic disease, except patients with < 3 X ULN LFTs indicative of hepatic steatosis – Past or current history of cancer, except for basal cell carcinoma or in situ cancer of the cervix – History of glucocorticoid therapy within the past 6 months, current treatment with any chemotherapeutic agents or exogenous GH therapy – History of investigational drugs administered or received within 30 days of study entry – Known hypersensitivity to octreotide LAR – Any other concomitant illnesses or therapy that would interfere with evaluation of efficacy or safety or increase the risk for study interruption or discontinuation in the opinion of the investigator or sponsor

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Cedars-Sinai Medical Center
  • Collaborator
    • Novartis Pharmaceuticals
  • Provider of Information About this Clinical Study
    • Principal Investigator: John Carmichael, Co Director, Pituitary Program At Keck Medical Center – University of Southern California
  • Overall Official(s)
    • John Carmichael, MD, Principal Investigator, University of Southern California

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