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Growth Hormone Rebound After Cessation of SMS 201-995 Treatment in Acromegaly

Published online by Cambridge University Press:  18 September 2015

L. Charest ,
R. Comtois ,
H. Beauregard  and
O. Serri
L. Charest
Affiliation:
Department of Medicine, Endocrinology Division, Notre-Dame Hospital, University of Montreal
R. Comtois*
Affiliation:
Department of Medicine, Endocrinology Division, Notre-Dame Hospital, University of Montreal
H. Beauregard
Affiliation:
Department of Medicine, Endocrinology Division, Notre-Dame Hospital, University of Montreal
O. Serri
Affiliation:
Department of Medicine, Endocrinology Division, Notre-Dame Hospital, University of Montreal
*
Endocrinology, Notre-Dame Hospital, 1560 Sherbrooke East, Montréal, Québec Canada H2L 4K8
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Abstract:

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We studied a 42-year-old woman who had persistent active acromegaly despite conventional therapies. She was treated for 6 months with SMS 201-995. Her mean plasma growth hormone GH values decreased during treatment from 9.1 ± 1.2 to 6.6 ± 1.2 µg/L. One month after the withdrawal of SMS 201-995, the plasma GH level increased to 24.4 µg/L (P < 0.001). This elevation was clinically silent and transitory, as GH levels decreased 8 months later to 6.9 ± 1.3 µg/L. Furthermore, at the beginning of therapy, her intractable headache was completely relieved; however, it progressively resumed under therapy. In conclusion, cessation of SMS 201-995 may be followed in some acromegalic patients by a rebound of plasma GH levels. This rebound suggests that SMS 201-995 decreases GH levels by an inhibition of its release from the pituitary. Furthermore, SMS 201-995 may relieve intractable headache in some acromegalic patients, but tolerance to the analgesic effect may develop.

Résumé:

RÉSUMÉ:

Nous avons évalué une malade de 42 ans qui demeurait avec une acromégalie active en dépit des traitements conventionnels. Elle fût donc traitée pendant 6 mois avec du SMS 201-995. Ses niveaux moyens d'hormone de croissance (GH) ont diminué en cours de traitement de 9.1 ± 1.2 à 6.6 ± 1.2 µg/L. Un mois après l'arrêt du SMS 201-995, les valeurs moyennes plasmatiques du GH avaient augmenté à 24.4 µg/L (P < 0.001). Cette hausse fût cliniquement silencieuse et transitoire; ainsi, les niveaux de GH diminuaient à 6.9 ± 1.3 µg/L, 8 mois plus tard. De plus, les céphalées rebelles de la malade sont complètement disparues au début de la thérapie. Cependant, au cours du traitement, les céphalées sont progressivement réapparues. En conclusion, l'arrêt de SMS 201-995 peut être suivi chez certains acromégales par un rebond des niveaux plasmatiques de GH. Ce rebond suggère que le SMS 201-995 diminue les niveaux de GH par une inhibition de sa relâche hypophysaire. De plus, le SMS 201-995 peut soulager les céphalées rebelles de certains acromégales; toutefois, il peut se développer une certaine tolérance à cet effet analgésique.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 16 , Issue 4 , November 1989 , pp. 442 - 445
Copyright
Copyright © Canadian Neurological Sciences Federation 1989

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