Clinical value of monitoring plasma octreotide levels during chronic octreotide long-acting repeatable therapy in carcinoid patients.

Abstract:

OBJECTIVE:Octreotide is used to treat patients with neuroendocrine tumors. Previous reports show that octreotide long-acting repeatable (LAR) dose and patient body weight affect nadir plasma octreotide levels (approximately 1250, 2500, 5000, and 11,000 pg/mL for LAR doses of 10, 20, 30 and 60 mg/mo). However, plasma octreotide levels have decreased over time in patients receiving these doses of LAR. METHODS:From November 2004 until July 2007, trough plasma octreotide levels were determined in 86 patients on long-term octreotide LAR therapy at doses of 30, 60, and 120 mg/mo. Changes in plasma drug levels were analyzed over time using random effects models. RESULTS:Current plasma octreotide levels for octreotide LAR doses of 30, 60, and 120 mg/mo are approximately 2200, 5200, and 6500 pg/mL, respectively, representing a decrease of approximately 50% to 70% compared with previously reported plasma octreotide levels. The decreases in octreotide levels over time with the 30- and 60-mg/mo LAR doses are highly statistically significant (P = 0.0067, 0.0149, respectively). CONCLUSIONS:Current plasma octreotide values are significantly lower than previously reported for 30-, 60-, and 120-mg/mo LAR doses. Serial plasma octreotide value measurements should be used to determine if increasing symptoms or tumor growth are associated with suboptimal octreotide levels.

journal_name

Pancreas

journal_title

Pancreas

authors

Woltering EA,Salvo VA,O'Dorisio TM,Lyons J 3rd,Li G,Zhou Y,Seward JR,Go VL,Vinik AI,Mamikunian P,Mamikunian G

doi

10.1097/MPA.0b013e31816907ab

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

94-100

issue

1

eissn

0885-3177

issn

1536-4828

pii

00006676-200807000-00014

journal_volume

37

pub_type

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