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 .- 67 . (canceled)
68 . A method of treating acromegaly in a subject in need thereof, the method comprising:
administering the subject oral octreotide with an initial dosage of 40 mg daily;
monitoring the subject's IGF-1 blood levels and/or acromegaly symptoms following administration of the 40 mg daily dosage and determining that the subject's IGF-1 blood levels are at least 1.3 times the upper limit of normal and/or symptoms are exacerbated;
adjusting the subject's dosage of oral octreotide to 60 mg daily;
monitoring the subject's blood levels of IGF-1 and/or acromegaly symptoms following administration of the 60 mg daily dosage and determining that the subject's IGF-1 blood levels are at least 1.3 times the upper limit of normal and/or symptoms are exacerbated;
adjusting the subject's dosage of oral octreotide to 80 mg daily;
monitoring the subject's IGF-1 blood levels and/or acromegaly symptoms following administration of 80 mg daily dosage and determining that the subject's IGF-1 blood levels are at least 1.3 times the upper limit of normal and/or symptoms are exacerbated; and
co-administering to the subject 80 mg oral octreotide daily and cabergoline.
69 . The method of claim 68 , wherein the maximum cabergoline dose is 3.5 mg/week.
70 . The method of claim 69 , wherein the cabergoline is administered 0.5 mg×2/week for the first two weeks, 1 mg×2/week for an additional two weeks, followed by 1.5 mg×2/week for an additional two weeks, and increased to a maximum of 1.75 mg×2/week.
71 . The method of claim 69 , wherein cabergoline is administered at a dose of 0.5 mg twice per week, 1 mg twice per week, 1.5 mg twice per week, or 1.75 mg twice per week.
72 . The method of claim 69 , wherein cabergoline is administered at a dose up to 0.5 mg/day per week for a total of 3.5 mg per week, or 1 mg three times a week for a total of 3.0 mg per week.
73 . The method of claim 68 , wherein the 40 mg, 60 mg, and/or oral octreotide is administered daily in two equal or unequal dosages.
74 . The method of claim 68 , wherein the 40 mg oral octreotide is administered daily in a morning dose and evening dose of 20 mg each.
75 . The method of claim 68 , wherein the 60 mg oral octreotide is administered daily in a 40 mg morning dose and 20 mg evening dose.
76 . The method of claim 68 , wherein the 80 mg oral octreotide is administered daily in a morning dose and evening dose of 40 mg each.
77 . The method of claim 68 , wherein the patient's IGF-1 blood levels are at least 1.3 times the upper limit of normal to two times the upper limit of normal following administration of 40 mg, 60 mg, or 80 mg daily of oral octreotide.