Recent advances in somatostatin analogues in acromegaly and patient satisfaction

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Somatostatin analogues (SSAs) are one of the main drugs for the treatment of acromegaly (hereinafter referred to as "limb enlargement")¹, normally, patients treated with SSA need to go to the hospital every four weeks for injection treatment, the perception of different SSA use and patient satisfaction with SSA injection regimen have an important impact on the long-term management of patients with limb enlargement, and choosing the appropriate treatment plan is of great significance
to improve the treatment compliance of patients with limb enlargement.
Today we will conduct an in-depth analysis
of the preferences of different SSAs and patients' satisfaction with different SSA treatment options.

Introduction by experts

Seeking South

Head nurse of the Second Endocrinology Region of the First Affiliated Hospital of Sun Yat-sen University

Nurse in charge, master's degree

Member of Diabetes Education Committee of Guangdong Medical Doctor Association

Member of the expert database of the Endocrine Nursing Committee of Guangdong Nursing Association

Clinical research directions: internal medicine (diabetes) nursing, endocrine nursing, hemodialysis nursing

Factors influencing SSA preference and patient receiving SSA treatment

SSA is the first-line drug therapy for patients with limb enlargement2, and most patients treated with SSA require long-term injection therapy, and previous studies have shown that usage preference and patient satisfaction have an important impact
on improving patient compliance and improving patient outcomes.

➤The long preparation and administration time of different SSAs, easy blockage, safety, and cumbersome operation of syringe devices are important factors
affecting nurses' preferences.
A quantitative study evaluating nurses using long-acting octreotide and lanreotide sustained-release gel (ATG) injection devices, using device attribute evaluation tables, scored the two devices separately, and listed the most important 5 attributes, the results showed ³, of the five device attributes that nurses considered most important, 70% of nurses considered the most important to be easy/convenient to prepare and inject, followed by 58% of nurses who considered the risk of syringe blockage to be low, and 42% of nurses think it's a safety issue
.
Preference studies in other therapeutic areas have shown that nurses prefer pre-filled systems that do not require recombination and are more convenient
to operate than vial systems.

Table 1.
Injection device attribute scores

➤The efficacy and treatment cost of different SSAs are important factors
affecting the conversion plan of patients.
An open-label, prospective, observational, multicenter study evaluating the satisfaction and preference of adults with large limbs who had previously received other SSAs and switched to lanreotide ATG showed that 1,44.
2% of patients were dissatisfied with the response and 33.
6% were switched from long-acting octreotide to lanreotide ATG due to treatment costs (Figure ¹).

Another meta-analysis showed that ^efficacy and cost of treatment were also key factors
in patients' consideration of continued medication.

Figure 1.
Reasons why patients switch from long-acting octreotide to lanreotide ATG

So, which SSA is preferable to nurses and improve patient satisfaction?

Nurses prefer SSA regimens with a lower risk of blockage and a high safety profile

At present, the long-acting SSA commonly used in clinical practice in China is Lanreotide ATG and long-acting octreotide, under normal circumstances, Lanreotide ATG and long-acting octreotide need to be injected every four weeks, but Lanreotide ATG has been approved to extend the interval between administration
.
Several studies have shown that for nurses, Lanreotide ATG injection treatment has the following advantages:

➤Higher preference scores: In one quantitative study, nurses rated 63% higher overall preference for lanreotide ATG compared with long-acting octreotide (Figure 2)³, and 97.
8% of nurses preferred lanreotide ATG⁵
.

Figure 2.
Overall preference scores of nurses for lanreotide ATG and long-acting octreotide

➤ Shorter preparation and dosing time: A quantitative study evaluating the opinions of nurses in Europe and the United States on SSA injection devices, including the recently approved new Lanreotide ATG device, showed that the preparation and administration time for Lanreotide ATG injection was significantly shorter than that of long-acting octreotide (mean time: 66s vs.
329s; P<0.
01) (Figure 3)³
。

Figure 3.
Lanreotide ATG vs long-acting octreotide injection preparation and administration time

➤Lower risk of syringe blockage: A multicenter, prospective, non-interventional, simulated use study showed that the Lanreotide ATG score was consistently higher than the long-acting octreotide in terms of syringe performance grade scores, especially in terms of "confidence that the syringe will not become blocked", with the largest significant difference between Lanreotide ATG and long-acting octreotide (P<0.
0001) (Figure 4)⁵
。

Figure 4.
Syringe rating based on 9 properties

➤The new device is safer and easier to operate: an open, multi-center study showed that compared with the previous long-acting octreotide, Lanreotide ATG has fewer technical problems and high safety performance; And the new Lanreotide ATG device is easier to ^operate1
.

SSA regimens with higher patient satisfaction

Acceptance of the injecting device affects patient adherence to treatment, and satisfaction with the outcome of treatment also influences
patient choice of treatment regimen.
Several studies have shown that the new Lanreotide ATG device has the following advantages for patients receiving long-term injection therapy:

➤ Lanreotide ATG is more convenient and more acceptable to patients: In a prospective, observational study, 64.
5% of patients found the new Lanreotide ATG device more ^convenient1
.
Another phase III, multicenter, open-label study showed greater acceptance of switching from long-acting octreotide to lanreotide ATG (Figure 5)⁶
.

Figure 5.
Patient acceptance after conversion of long-acting octreotide to lanreotide ATG regimen

➤ Patients treated with Lanreotide ATG have a better injection experience: An open-label study showed that 75% of patients found it very convenient to use Lanreotide ATG injection; 50% of patients rated Lanreotide ATG injection as painless and had a better injection experience (Figure 6)⁷
.

Figure 6.
Patient experience after injection

➤ Better satisfaction in patients treated with lanreotide ATG: In a prospective, observational study evaluating the satisfaction and preference of adults with large limbs who had previously received other SSAs converted to lanreotide ATG, 95.
1% of patients who switched from long-acting octreotide to lanreotide ATG were completely or reasonably satisfied with the efficacy of lanreotide ATG (Figure 7)¹
。

Figure 7.
Patient satisfaction with lanreotide ATG therapy

In summary, the new syringe of Lanruotide ATG has the advantages of shorter preparation and administration time, low risk of blockage, higher safety and simple operation, which brings simplicity of operation to nurses and reduces the burden
of clinical work.
At the same time, Lanruotide ATG has the characteristics of convenient operation and higher patient acceptance; Treatment with Lanreotide ATG brings patients a better injection experience, and its efficacy can help patients better control the disease and improve patient satisfaction
.
These are not only conducive to improving patient compliance, but also create conditions
for long-term medication by patients.
It can be seen that Lanruotide ATG has considerable clinical prospects, and it is expected to benefit more patients with limbs at home and abroad in the future!

Expert reviews

SSA is an important method for treating limb enlargement, and preference for SSA is a key factor for effective treatment.
Patient acceptance of SSA has an impact on the effectiveness of their treatment and the duration of treatment, so the choice of injection regimen is critical for patients to adhere to long-term treatment and achieve good results.

"Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly (2020 Edition)" pointed out that the choice of Lanreotide ATG depends on the practicality, convenience and patient preference of ^{administration8}, Lanreotide ATG new device is improved on the basis of the original syringe, bringing better convenience to patients, a number of studies have confirmed the advantages of Lanreotide ATG new device, whether for clinicians or patients receiving injection treatment.
The new device for Lanreotide ATG is the preferred option for long-term injections!

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.

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.
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Experimental and Clinical Endocrinology &Diabetes.
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Endocrinology Branch of Chinese Medical Association Chinese expert consensus on the diagnosis and treatment of acromegaly (2020 edition)[J] Chinese Journal of Endocrinology and Metabolism,2020,36(09):751-760

Approval number: SOM-CN-001449

Validity: November 09, 2023