Treatment effects on MEPE, FGF-23 and phosphorus. At 16 years of age, with a history of hypophosphatemia, musculoskeletal symptoms, recurrent insufficiency fractures and an elevated plasma level of FGF-23, octreotide therapy (Oct TX) was begun along with ongoing phosphate and calcitriol therapy. Initially octreotide acetate 50 mcg was administered subcutaneously daily for 3 days, followed by Sandostatin LAR depot 10 mg intramuscularly every 2 weeks for 4 months. Six months after completing the Sandostatin LAR, excision surgery was performed for cosmetic reasons. The levels of FGF-23 (open circle), serum phosphorus (open triangle), calculated TmP/GFR (solid triangle) (panel a) and total plasma MEPE (solid square) and ASARM peptide (open square) (panel b) were followed for up to 2.5 years after surgery.