A Multicenter Experience with Long-Acting Somatostatin Analogues in Patients with Congenital Hyperinsulinism

Horm Res Paediatr. 2018;89(2):82-89. doi: 10.1159/000485184. Epub 2017 Dec 14.

Abstract

Background/aims: Congenital hyperinsulinism (CHI) is a rare disease characterized by recurrent severe hypoglycemia. In the diffuse form of CHI, pharmacotherapy is the preferred choice of treatment. Long-acting somatostatin analogues have been used in children as off-label medication. However, the efficacy, outcomes, and adverse effect profiles of long-acting somatostatin analogues have not been described in multicentered studies. The aim of this retrospective study is to summarize the experience with long-acting somatostatin analogues in a large group of children with CHI.

Methods: Data were obtained retrospectively from 27 patients with CHI who received long-acting somatostatin analogues in 6 different centers in Europe. These included information on glycemic stability, auxology, and adverse effect profile in clinical follow-up assessments.

Results: Blood glucose control improved in most patients (89%). No life-threatening side effects occurred. Thirteen patients (48%) experienced side effects; in 3 patients (11%), the side effects were the main reason for discontinuation of the treatment. The most frequent side effect was elevated liver enzymes (n = 10, 37%).

Conclusion: Long-acting somatostatin analogues are effective in glycemic control of patients with CHI. However, in 37% of all patients increased liver enzymes were observed. It is important to monitor liver function in all patients receiving long-acting somatostatin analogue therapy.

Keywords: Congenital hyperinsulinism; Glycemic control; Lanreotide; Sandostatin-LAR; Somatostatin analogue; Treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Blood Glucose / metabolism*
  • Congenital Hyperinsulinism / blood
  • Congenital Hyperinsulinism / drug therapy*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use*
  • Peptides, Cyclic / therapeutic use*
  • Retrospective Studies
  • Somatostatin / analogs & derivatives*
  • Somatostatin / therapeutic use
  • Treatment Outcome

Substances

  • Blood Glucose
  • Peptides, Cyclic
  • sandostatinLAR
  • lanreotide
  • Somatostatin
  • Octreotide