lanreotide (somatotropin, growth hormone, GH, hGH, rhGH, Humatrope, Protropin, Serostim, Somatrem, Somatuline)

Introduction

Tradenames: Humatrope, Protropin, Serostim

Indications

• long-term treatment of growth failure from lack of adequate endogenous growth hormone
  • dwarfism
• treatment of AIDS wasting or cachexia (Serostim)
• growth hormone deficiency in the elderly?

Contraindications

• proliferative diabetic retinopathy
• malignancy

Dosage

• somatrem (Protropen): 0.1 mg (0.26 units)/kg/dose 3X/week
• somatropin
  • Humatrope: 0.06 mg (0.16 units)/kg/dose 3X/week
  • Serostim: 0.1 mg/kg SC QHS
  • Somatuline: 60-120 mg IM every 4 weeks
    • injected in the superior external quadrant of the buttock; injection site should be alternated
• 5-10 ug/kg/day SC QHS

Therapy should be discontinued when patient has reached a satisfactory adult height, when epiphyses have fused, or when patient ceases to respond.

Injection:

• somatrem (Protropin) 5 mg - 13 units
• somatropin
  • Humatrope: 3 mg = 13 units
  • Serostim: 6 mg = 18 units

Monitor

serum IGF-1

Adverse effects

• common
  • diarrhea (37%)
  • cholelithiasis (20%)
  • abdominal pain (19%)
  • nausea (11%)
  • injection-site reaction (9%)
  • flatulence (7%)
  • arthralgia (7%)
• not common (1-10%)
  • hypothyroidism
• uncommon (< 1%)
  • hyperglycemia
  • small risk of developing leukemia
  • pain at site of injection
  • rash, itching
  • pain in knee &/or hip
• other {dose-dependent}
  • fluid retention
  • glucose intolerance
  • carpal tunnel syndrome
  • gynecomastia, breast tenderness
  • increased risk of death

Mechanism of action

• stimulates IGF-1 secretion
• increased lean body mass
• increased bone mass
• increased skin thickness
• decreased adipose tissue
• does not add to beneficial effect of exercise
• does not improve athletic performance

Complications

• adrenal insufficiency in unrecognized ACTH deficiency

Notes

• teen use
  • black & Hispanic teens more likely than white teens to use HGH (15% & 13%, respectively, vs. 9%)
  • both boys & girls use synthetic HGH (12% & 9%, respectively)
  • 81% of teens view HGH use moderately to very risky

More general terms

• somatotropin; growth hormone; somatropin (GH)
• endocrine agent

Additional terms

• acromegaly
• growth hormone (GH) stimulation test
• growth hormone (GH) suppression test; glucose challenge test for acromegaly
• growth hormone (somatotropin) in serum
• growth hormone receptor; GH receptor; somatotropin receptor; contains: growth hormone-binding protein; GH-binding protein; GHBP; serum-binding protein (GHR)
• growth hormone-releasing hormone; somatotropin-releasing hormone,; somatocrinin; somatoliberin (GHRH)
• pituitary adenoma/GH secreting (somatotrophinoma)