From the FDA Drug Label
- 4 Thyroid Function Abnormalities Slight decreases in thyroid function have been seen during treatment with lanreotide in acromegalic patients, though clinical hypothyroidism is rare (less than 1%). Thyroid function tests are recommended where clinically indicated.
Lanreotide may compromise thyroid function, as slight decreases in thyroid function have been observed in patients treated with lanreotide. However, clinical hypothyroidism is rare (less than 1%). It is recommended to monitor thyroid function tests where clinically indicated 1.
From the Research
Lanreotide can potentially compromise thyroid function, particularly in patients with pre-existing thyroid disease or those on long-term, high-dose therapy, as evidenced by the most recent study in 2021 2.
Mechanism of Action
Lanreotide, a somatostatin analog, primarily targets growth hormone and insulin-like growth factor 1, but it may indirectly influence thyroid function through several mechanisms. It can reduce thyroid-stimulating hormone (TSH) secretion from the pituitary gland and may decrease blood flow to the thyroid gland, potentially affecting hormone production. Additionally, lanreotide can inhibit peripheral conversion of T4 to the more active T3 hormone.
Clinical Implications
Patients on lanreotide therapy, particularly those being treated for acromegaly or neuroendocrine tumors, should have their thyroid function monitored periodically with standard thyroid function tests (TSH, free T4) 2. Most thyroid effects are mild and subclinical, but if clinical hypothyroidism develops, standard thyroid hormone replacement therapy with levothyroxine can be initiated while continuing lanreotide treatment.
Risk Factors
The risk of clinically significant thyroid dysfunction is higher in patients with pre-existing thyroid disease or those on long-term, high-dose lanreotide therapy 2. Therefore, it is essential to carefully monitor thyroid function in these patients and adjust treatment accordingly.
Monitoring and Management
Regular monitoring of thyroid function is crucial in patients receiving lanreotide therapy. This includes periodic measurements of TSH, free T4, and other thyroid function tests as needed 3, 4, 5. If thyroid dysfunction is detected, appropriate management strategies can be implemented to minimize the risk of morbidity and mortality.
Key Considerations
- Lanreotide can potentially compromise thyroid function, particularly in patients with pre-existing thyroid disease or those on long-term, high-dose therapy.
- Regular monitoring of thyroid function is essential in patients receiving lanreotide therapy.
- Patients with clinical hypothyroidism can be treated with standard thyroid hormone replacement therapy while continuing lanreotide treatment.
- The risk of clinically significant thyroid dysfunction is higher in patients with pre-existing thyroid disease or those on long-term, high-dose lanreotide therapy.