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Sandostatin LAR Depot vs. Surgery for Treating Acromegaly

Primary Purpose

Acromegaly, Pituitary Neoplasm

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Sandostatin LAR Depot versus transsphenoidal surgery
Sponsored by
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acromegaly focused on measuring Growth Hormone, Somatostatin, Insulin-like Growth Factor-One, Acromegaly, Macroadenoma

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA: Male or female patients, 18 years of age or older. Newly diagnosed patients with acromegaly, or previously untreated. Presence of a pituitary tumor greater than 10 mm at greatest diameter (macroadenoma). Lack of suppression of GH to less than 2.0 ng/mL using a regular GH RIA, or less than one ng/mL using a two-site immunoradiometric or chemiluminescent GH assay, after oral administration of 100 g of glucose. IGF-1 levels above the upper limits of normal (adjusted for age and gender). Demonstrated tolerance to a test dose of s.c. Sandostatin Injection. Demonstrated responsiveness to a 100 ug s.c. Sandostatin Injection test dose, as evidenced by suppression of mean 4HR GH to less than 5 ng/mL, or to greater than 50 % of the baseline value. Patients who are able to provide written informed consent. EXCLUSION CRITERIA: Patients demonstrating intolerance to a s.c. Sandostatin (octreotide acetate) test dose. Patients who have received any prior treatment for their acromegaly, including radiotherapy, octreotide, bromocriptine, lanreotide, or prior surgery. Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control. Patients with compression of the optic chiasm significant enough to cause visual field defects on automated testing. Patients who require surgery for relief of any neurologic signs or symptoms associated with their tumor. Patients with symptomatic cholelithiasis. Patients who have congestive heart failure (NYHA Class III and IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, or a history of acute myocardial infarction within the three months preceding study entry. Patients with liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis, or persistent ALT, AST, or alkaline phosphatase 2X greater than upper limit of normal; or direct bilirubin more than 10% greater than upper limit of normal. Patients with abnormal clinical laboratory values considered by the Investigator or the Sponsor's Medical Monitor to be clinically significant and which could affect the interpretation of the study results. Patients who have any current or prior medical condition that may interfere with the conduct of the study or of the evaluation of its result in the opinion of the Investigator or Sponsor's Medical Monitor. Patients who have a history of alcohol or drug abuse in the six month period prior to Visit 1. Patients who have received any investigational drug within one month prior to Visit 1, or who plan to take an investigational drug during the study. Patients with any mental impairment limiting their ability to comply with all study requirements. Patients who, for any reason, will be unable to complete the entire study.

Sites / Locations

  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 3, 1999
Last Updated
March 3, 2008
Sponsor
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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1. Study Identification

Unique Protocol Identification Number
NCT00001860
Brief Title
Sandostatin LAR Depot vs. Surgery for Treating Acromegaly
Official Title
Sandostatin LAR vs. Surgery in Acromegalics With Macroadenoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2002
Overall Recruitment Status
Completed
Study Start Date
August 1999 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
July 2002 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to compare the efficacy of Sandostatin LAR® (Registered Trademark) Depot to transsphenoidal surgery in previously untreated acromegalic patients with macroadenomas. The primary goal is to normalize insulin-like growth factor-1 (IGF-1) levels. Secondary goals are to compare Sandostatin LAR® (Registered Trademark) Depot treatment and transsphenoidal surgery to achieve the following goals: suppress growth hormone levels to less than or equal to 2.5 ng/mL, relieve the clinical signs and symptoms of acromegaly, reduce the size of the macroadenomas, produce few side effects, assess the prognostic value of baseline pituitary adenoma size, extension and baseline growth hormone level on post-treatment growth hormone and IGF-1 levels, and assess the resource utilization of each treatment type.
Detailed Description
The purpose of this study is to compare the efficacy of Sandostatin LAR® (Registered Trademark) Depot to transsphenoidal surgery in previously untreated acromegalic patients with macroadenomas. The primary goal is to normalize insulin-like growth factor-1 (IGF-1) levels. Secondary goals are to compare Sandostatin LAR® (Registered Trademark) Depot treatment and transsphenoidal surgery to achieve the following goals: suppress growth hormone levels to less than or equal to 2.5 ng/mL, relieve the clinical signs and symptoms of acromegaly, reduce the size of the macroadenomas, produce few side effects, assess the prognostic value of baseline pituitary adenoma size, extension and baseline growth hormone level on post-treatment growth hormone and IGF-1 levels, and assess the resource utilization of each treatment type.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acromegaly, Pituitary Neoplasm
Keywords
Growth Hormone, Somatostatin, Insulin-like Growth Factor-One, Acromegaly, Macroadenoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Enrollment
5 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Sandostatin LAR Depot versus transsphenoidal surgery

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Male or female patients, 18 years of age or older. Newly diagnosed patients with acromegaly, or previously untreated. Presence of a pituitary tumor greater than 10 mm at greatest diameter (macroadenoma). Lack of suppression of GH to less than 2.0 ng/mL using a regular GH RIA, or less than one ng/mL using a two-site immunoradiometric or chemiluminescent GH assay, after oral administration of 100 g of glucose. IGF-1 levels above the upper limits of normal (adjusted for age and gender). Demonstrated tolerance to a test dose of s.c. Sandostatin Injection. Demonstrated responsiveness to a 100 ug s.c. Sandostatin Injection test dose, as evidenced by suppression of mean 4HR GH to less than 5 ng/mL, or to greater than 50 % of the baseline value. Patients who are able to provide written informed consent. EXCLUSION CRITERIA: Patients demonstrating intolerance to a s.c. Sandostatin (octreotide acetate) test dose. Patients who have received any prior treatment for their acromegaly, including radiotherapy, octreotide, bromocriptine, lanreotide, or prior surgery. Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth control. Patients with compression of the optic chiasm significant enough to cause visual field defects on automated testing. Patients who require surgery for relief of any neurologic signs or symptoms associated with their tumor. Patients with symptomatic cholelithiasis. Patients who have congestive heart failure (NYHA Class III and IV), unstable angina, sustained ventricular tachycardia, ventricular fibrillation, or a history of acute myocardial infarction within the three months preceding study entry. Patients with liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis, or persistent ALT, AST, or alkaline phosphatase 2X greater than upper limit of normal; or direct bilirubin more than 10% greater than upper limit of normal. Patients with abnormal clinical laboratory values considered by the Investigator or the Sponsor's Medical Monitor to be clinically significant and which could affect the interpretation of the study results. Patients who have any current or prior medical condition that may interfere with the conduct of the study or of the evaluation of its result in the opinion of the Investigator or Sponsor's Medical Monitor. Patients who have a history of alcohol or drug abuse in the six month period prior to Visit 1. Patients who have received any investigational drug within one month prior to Visit 1, or who plan to take an investigational drug during the study. Patients with any mental impairment limiting their ability to comply with all study requirements. Patients who, for any reason, will be unable to complete the entire study.
Facility Information:
Facility Name
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
2663476
Citation
Barkan AL. Acromegaly. Diagnosis and therapy. Endocrinol Metab Clin North Am. 1989 Jun;18(2):277-310.
Results Reference
background
PubMed Identifier
8327647
Citation
Bates AS, Van't Hoff W, Jones JM, Clayton RN. An audit of outcome of treatment in acromegaly. Q J Med. 1993 May;86(5):293-9.
Results Reference
background
PubMed Identifier
9709926
Citation
Melmed S, Jackson I, Kleinberg D, Klibanski A. Current treatment guidelines for acromegaly. J Clin Endocrinol Metab. 1998 Aug;83(8):2646-52. doi: 10.1210/jcem.83.8.4995.
Results Reference
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Sandostatin LAR Depot vs. Surgery for Treating Acromegaly

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