ESA News

ESA Newsletter: November 2003

New product for acromegaly

For the first time in Australia,a somatostatin analogue is available in a pre-filled syringe. New Somatuline® Autogel® (lanreotide) is indicated for the treatment of acromegaly when the circulating levels of growth hormone and IGF-1 remain abnormal after surgery and/or radiotherapy, or in patients who are dopamine agonist treatment refractory.

In clinical trials, Somatuline Autogel has been found to be effective at reducing growth hormone, IGF-1 levels and clinical symptoms, and is well-tolerated.^1,2

Somatuline Autogel is available in 60 mg, 90 mg and 120 mg formulations for administration every 28 days. Formulated for deep subcutaneous injection, Somatuline Autogel has a small injection volume (0.2 –0.4 mL) and reconstitution is not required, due to its ready-to-use presentation. Pharmacokinetic analysis reveals a smooth, sustained release profile, providing therapeutic plasma levels of lanreotide for at least 28 days.³

PBS Information: This product is not listed on the PBS.
Please review Product Information before prescribing.

References:
1. Caron PH et al.J Clin Endocrinol Metabol 2002:87 :99 –104.
2.Caron PJ.Poster presented at the Endocrine Society 's 84th Annual Meeting, June 2002, San Francisco (data on file, 710, Ipsen Ltd).
3.Australian Product Information: Somatuline Autogel (9 September 2003).
 

Study Results From Clinical Members Survey

In 2001, ESA clinical members participated in a survey of the management of multinodular goitre.The results have now been published (Bhagat et al.Differences between endocrine surgeons and endocrinologists in the management of nontoxic multinodular goitre.British Journal of Surgery, 2003; 90: 1103-1112). A copy of the paper can be emailed to ESA members on request.
Contact: suzana.gegoff@health.wa.gov.au
John Walsh,Sir Charles Gairdner Hospital.Nedlands,WA.

The abstract is given below:

Background: It is not known whether the management of multinodular goitre differs between endocrinologists and endocrine surgeons.

Methods: A questionnaire containing a hypothetical case (a 42-year-old euthyroid woman with a 50-80-g multinodular goitre) and 11 variations on the case was sent
to endocrinologists and endocrine surgeons in Australia.

Results: The response rate was 55 per cent, including 45 endocrine surgeons and 127 endocrinologists. For the index case, serum thyroid-stimulating hormone (TSH), fine-needle aspiration biopsy and ultrasonography were widely used by both groups.
Thyroid antibodies and scintigraphy were ordered by a greater proportion of endocrinologists than surgeons, and computed tomography more frequently by surgeons than endocrinologists. Treatment recommendations differed significantly between specialties for the index case (endocrinologists: no treatment 65 per cent,
thyroxine 22 per cent, surgery 10 per cent, radioiodine 3 per cent; surgeons:no treatment 67 per cent, thyroxine 2 per cent, surgery 31 per cent; P <0.001) and for seven of the variations.In particular, for a patient with suppressed TSH, most endocrinologists (60 per cent) recommended radioiodine treatment, whereas there was no consensus among surgeons (surgery 40 per cent, no treatment 36 per cent, radioiodine 21 per cent). For a patient with a partly intrathoracic goitre, most surgeons (88 per cent) recommended surgery, whereas there was no consensus among endocrinologists (surgery 45 per cent, no treatment 34 per cent, thyroxine treatment 13 per cent, radioiodine 8 per cent).

Conclusion: There are clinically significant differences between endocrine surgeons and endocrinologists in the management of multinodular goitre. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley &Sons, Ltd.

©British Journal of Surgery Society Ltd.Reproduced with permission.Permission is granted by John Wiley &Sons Ltd on behalf of BJSS Ltd.

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