Octreotide LAR doses used in clinical practice: Results from an internet survey and a clinical practice

Abstract

4274 Background: Octreotide acetate LAR (LAR) is approved for the control of symptoms from carcinoid syndrome and VIPoma. Recommended LAR doses from the package label are 20 and 30 mg administered monthly. Physicians commonly confront clinical scenarios requiring titration of LAR to doses that control symptoms. We hypothesized that physicians commonly employed doses extending beyond those tested during the registrational period. To test this hypothesis, a physician practice and a patient support group were surveyed. Methods: An internet survey conducted with a yahoo carcinoid patient support group (N=93) (with no individual subject identifiers) and a survey of a physician office practice database using the ICD-9 code of 259.2 (carcinoid syndrome) were conducted (N=309). Results: Of the 93 patients responding to the internet survey, 28 (30%) were on LAR doses > 30 mg / mo as follows: 13 pts, 40 mg; 1 pt, 50 mg: 13 pts, 60 mg; 1 pt, 80 mg. From 50 of the 309 chart reviews from the clinical practice, 36 patients were receiving LAR at doses ranging from 20 mg to 60 mg every 2 to 4 weeks. The most common dose was 30 mg every 4 wks (N=24) followed by 20 mg q 4 wks (N=6). Other doses ranged from 40 mg every 3 wks to 60 mg every 4 wks with 1 patient each at the following doses: 30 mg q 2 wks; 30 mg q 3 wks; 40 mg q 3 wks; 40 mg q 4 wks; 50 mg q 4 wks and 60 mg q Conclusions: Octreotide acetate LAR is prescribed at doses beyond the package label 17% (single physician practice) to 30% (patient survey) of the time.