Treatment with Somatuline Depot for 120 weeks reduced the growth of liver and combined liver and kidney volume in patients with polycystic liver disease due to autosomal dominant polycystic kidney disease, according to results of a randomized control trial.
Rene M.M. van Aerts , MD, from Radboud University Medical Center in the Netherlands, and colleagues wrote that polycystic liver disease (PLD) is the most common extra-renal manifestation of autosomal dominant polycystic kidney disease (ADPKD) with a prevalence of 83%.
“Symptomatic PLD represents an unmet need for treatment aiming to reduce liver volume or reduce liver growth,” they wrote. “While the majority of PLD patients will remain asymptomatic, some patients develop hepatomegaly leading to abdominal pain, early satiety, shortness of breath, poor nutritional status and decreased quality of life (QoL).”
The researchers randomly assigned 175 patients with a total liver volume of 2,000 mL or higher to receive Somatuline Depot (lanreotide, Ipsen) or placebo (93 vs. 82).
At end of treatment, total liver volume adjusted for height decreased by 1.99% in the treatment group and increased by 3.92% in controls for an advantage of –5.91% (95% CI, –9.18 to –2.63). Four months after cessation, the beneficial effect of lanreotide remained significant (–3.87%; 95% CI, –7.55 to –0.18).
Combined liver and kidney volume adjusted for height increased by 2.21% in the treatment group compared with 9.39% in the control group for a treatment effect of –7.18% (95% CI, –10.25 to –4.12). Lanreotide continued to show a volume reducing effect on combined volume at 4 months posttreatment with a 5.43% lower increase compared with placebo (95% CI, –9.13 to –1.74).
Aside from hepatic cyst infections, which the researchers noted had been described previously, there were no significant differences in severe adverse event occurrence related to lanreotide between the groups.
“Our findings help to improve the understanding of the possible place of lanreotide treatment for PLD in the context of ADPKD,” van Aerts and colleagues wrote. “It provides evidence that suppression of the growth of cystic organs is part of the biological effect of somatostatin analogues. Therefore, in ADPKD patients with symptomatic PLD, long-term treatment with lanreotide should be considered.” – by Talitha Bennett
Disclosure: van Aerts reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.