Oral octreotide administered in combination with other therapeutic agents
This invention relates to combination therapy of a subject suffering from acromegaly. The method of treatment comprises administration to the subject of a therapeutically effective amount of oral somatostatin receptor ligand (SRL) e.g. octreotide in combination with a therapeutically effective amount of a dopamine agonist and/or a growth hormone receptor antagonist and/or a selective estrogen receptor modulator (SERM) and/or a 2 nd somatostatin receptor ligand (SRL).
1. A method of treating acromegaly in a subject in a subject who has failed to respond to oral octreotide capsules 80 mg daily for at least two weeks treatment, or has inadequate biochemical control on octreotide capsules 80 mg daily for at least two weeks treatment such that the subject's blood levels of IGF-1 are at least 1.3 times the upper limit of normal to two times the upper limit of normal, wherein the octreotide is co-administered at 40, 60 or 80 mg daily with cabergoline at up to 3.5 mg per week.
2. The method of claim 1 wherein the cabergoline may be administered twice weekly, preferably with dinner, with a fixed titration algorithm every two weeks, starting with 0.5 mg×2/week at the first two weeks, 1 mg×2/week for additional two weeks, followed by 1.5 mg×2/week, and increase to a maximum of 1.75 mg×2/week.
3. The method of claim 1 wherein the daily dose of cabergoline can be up to 0.5 mg/day, or up to 1 mg×3/week.