Medical Treatment of Acromegaly with SMS 201-995, a Somatostatin Analog: A Comparison with Bromocriptine*

Abstract

We studied the effects of acute and chronic s.c. administration of SMS 201-995 (SMS), a long-acting somatostatin analog, in acromegalic patients. The results were compared with those obtained in the same patients treated with oral bromocriptine (Brc). A single dose of 50 .mu.g SMS administered to 28 patients induced a more rapid, greater, and more prolonged reduction in plasma GH levels than did 2.5 mg Brc. Chronic treatment [60-330 days; mean 208 .+-. 23 (.+-. SEM)] with SMS (100-300 .mu.g/day) induced in 16 patients a significantly greater decrease in mean plasma GH and somatomedin-C levels than did 20 mg Bre. Combined treatment with the 2 agents had an additional effect. The clinical and metabolic parameters of acromegaly dramatically improved in all patients whose plasma GH and somatomedin-C levels decreased even if they were not normalized by SMS. Reduction in tumor size occurred in 3 of the 10 patients examined by computed tomography before and during SMS treatment.We conclude that SMS is more effective than Brc and that the 2 drugs may be complementary in the medical treatment of acromegaly.