Condition
Acromegaly
Acromegaly is a hormone condition in which the pituitary, usually through a benign tumor, makes too much growth hormone, gradually enlarging the hands, feet, and face. The evidence is strong for pegvisomant, octreotide, and lanreotide: trials found most people on pegvisomant reached normal IGF-1, while about half to 60% reached growth hormone control on the other two. Those results track hormone levels, not symptoms.
Sources: PMID 10770982; PMID 24606084; PMID 29357081
- Updated
- How we grade
- 100 studies cited
- Supplements studied
- 0
- Medicines and peptides
- 4
- Graded outcomes
- 13
No supplement studies yetWe haven’t found supplement studies for Acromegaly. The medicines and peptides studied for it are listed below.
Prescription medicines and peptides studied, for context
Pegvisomant (Somavert)
- Treatment-Resistant Acromegaly: improves
- Acromegaly Symptoms: improves
- IGF-1 Normalization: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Treatment-Resistant Acromegaly 100% IGF-1 normalization in octreotide-resistant patients. Effective after failed surgery and somatostatin analog therapy. | Improves (the measure goes down) | Large effect | 19 studies | |||
Studies that measured treatment-resistant acromegaly | ||||||
| Acromegaly Symptoms Improvement in soft tissue swelling, fatigue, perspiration, and joint symptoms associated with GH/IGF-1 excess. | Improves (the measure goes down) | Moderate effect | 19 studies | |||
| IGF-1 Normalization 97% achieved normal IGF-1 at 12 months in clinical trials. Phase III: 89% normalization with 20mg daily dose. Most effective medical therapy for biochemical control. | Changes; see studies | Large effect | 14 studies | |||
| Serum IGF-1 Levels Dose-dependent reduction: 62.5% decrease with 20mg/day vs 4% with placebo. German Observational Study showed sustained reduction from 1.75x to 0.89x ULN over 24 months. | Improves (the measure goes down) | Large effect | 14 studies | |||
| Glucose Metabolism Significant decrease in serum insulin and glucose concentrations (P<0.05). Particularly beneficial in acromegaly patients with coexistent diabetes mellitus. | Improves (the measure goes down) | Moderate effect | 14 studies | |||
Pasireotide (Signifor)
- GH Suppression (Acromegaly): improves
- IGF-1 Normalization: changes; see studies
Key findings
- Acromegaly SymptomsImproves (the measure goes down)
- GH Suppression (Acromegaly)Improves (the measure goes down)
- Treatment-Resistant AcromegalyImproves (the measure goes down)
Studies cited
100 studies from PubMed
- Lanreotide protects against LPS-induced inflammation in endothelial cells and mouse lungs.
- Comparative analysis of adverse event profiles of lanreotide and octreotide in somatostatin-responsive endocrine and neoplastic diseases.
- Safety profile of lanreotide: a retrospective post-marketing pharmacovigilance study based on the real-world data from FAERS database.
- Variations in Octreotide Dosing in Published Reports of Sulfonylurea Toxicity: A Systematic Review, 1988-Present.
- The use of octreotide in pediatric patients: Practical applications for gastrointestinal disorders and beyond: A narrative review.
- Real-world evidence of effectiveness and safety of pasireotide in the treatment of acromegaly: a systematic review and meta-analysis.
- Efficacy and Safety of Pasireotide in Insulinoma-Associated Hypoglycemia.
- Short- and long-term glycemic effects of pasireotide in patients with acromegaly: a comprehensive case study with review of literature.
- Impact of pasireotide on lipid and glucose metabolism in patients with acromegaly: a systematic review and meta-analysis.
- Personalized medicine in acromegaly: insights from the ACROFAST clinical trial.
- Medical treatment in acromegaly: a network meta-analysis.
- Pegvisomant in managing comorbidities of acromegaly: a review.
- Combined Lanreotide Autogel and Temozolomide Treatment of Progressive Pancreatic and Intestinal Neuroendocrine Tumors: The Phase II SONNET Study.
- An update on the safety of lanreotide autogel for the treatment of patients with neuroendocrine tumors.
- Octreotide Subcutaneous Depot for Acromegaly: A Randomized, Double-blind, Placebo-controlled Phase 3 Trial, ACROINNOVA 1
- Octreotide efficacy and safety in children with hyperinsulinism: evidence from two Chinese centers.
- Somatostatin Versus Octreotide for Prevention of Postoperative Pancreatic Fistula: The PREFIPS Randomized Clinical Trial: A FRENCH 007-ACHBT Study.
- Efficacy and safety of pasireotide treatment in acromegaly: A systematic review and single arm meta-analysis.
- Safety and antitumor activity of metformin plus lanreotide in patients with advanced gastro-intestinal or lung neuroendocrine tumors: the phase Ib trial MetNET2.
- Efficacy and Safety of Lanreotide Autogel and Temozolomide Combination Therapy in Progressive Thoracic Neuroendocrine Tumors (Carcinoid): Results from the Phase 2 ATLANT Study.
- Protein kinase C delta mediates Pasireotide effects in an ACTH-secreting pituitary tumor cell line.
- Pasireotide Versus Octreotide in Preventing Complications After Simultaneous Pancreas-Kidney Transplantation.
- Efficacy and Safety of Pegvisomant in the Treatment of Acromegaly.
- The Use of Lanreotide in the Treatment of Congenital Hyperinsulinism.
- Oral Octreotide: A Review of Recent Clinical Trials and Practical Recommendations for Its Use in the Treatment of Patients With Acromegaly
- IVIVC of Octreotide in PLGA-Glucose Microsphere Formulation, Sandostatin® LAR.
- Pasireotide for Refractory Hypoglycemia in Malignant Insulinoma- Case Report and Review of the Literature.
- Pasireotide-Induced Shrinkage in GH and ACTH Secreting Pituitary Adenoma: A Systematic Review and Meta-Analysis.
- Blockade of growth hormone receptor signaling by using pegvisomant: A functional therapeutic strategy in hepatocellular carcinoma.
- Pharmacological and safety profile of a prolonged-release lanreotide formulation in acromegaly.
- The use of high dose octreotide in management of neonatal chylothorax: Review.
- Octreotide and pasireotide effects on medullary thyroid carcinoma (MTC) cells growth, migration and invasion.
- Pasireotide treatment for severe congenital hyperinsulinism due to a homozygous ABCC8 mutation.
- Managing pasireotide-associated hyperglycemia: a randomized, open-label, Phase IV study.
- Effectiveness of Medical Treatment of Cushing's Disease: A Systematic Review and Meta-Analysis.
- Efficacy and safety of lanreotide autogel compared with lanreotide 40 mg prolonged release in Chinese patients with active acromegaly: results from a phase 3, prospective, randomized, and open-label study (LANTERN).
- Risk factors and management of pasireotide-associated hyperglycemia in acromegaly.
- Pansomatostatin Agonist Pasireotide Long-Acting Release for Patients with Autosomal Dominant Polycystic Kidney or Liver Disease with Severe Liver Involvement: A Randomized Clinical Trial.
- Cardiometabolic Risk in Acromegaly: A Review With a Focus on Pasireotide.
- Efficacy of Pasireotide for Prevention of Postoperative Pancreatic Fistula in Pancreatic Surgery: a Systematic Review and Meta-analysis.
- Meta-analysis on the Effect of Pasireotide for Prevention of Postoperative Pancreatic Fistula.
- Meta-Analysis on the Effect of Pasireotide for Prevention of Postoperative Pancreatic Fistula.
- Preconception use of pegvisomant alone or as combination therapy for acromegaly: a case series and review of the literature.
- Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies.
- Maintenance with lanreotide in small-cell lung cancer expressing somatostatine receptors: A multicenter, randomized, phase 3 trial.
- Lanreotide Reduces Liver Growth In Patients With Autosomal Dominant Polycystic Liver and Kidney Disease.
- Further Evidence That Lanreotide Reduces Liver Growth in Patients With Polycystic Liver Disease, But Not the End of the Story.
- Efficacy and safety of lanreotide in Korean patients with metastatic, well-differentiated gastroenteropancreatic-neuroendocrine tumors: a retrospective analysis.
- The safety of lanreotide for neuroendocrine tumor.
- Octreotide SC depot in patients with acromegaly and functioning neuroendocrine tumors: a phase 2, multicenter study
- Health-Related Quality of Life for Long-Acting Octreotide versus Placebo in Patients with Metastatic Midgut Neuroendocrine Tumors in the Phase 3 PROMID Trial
- Entering the third decade of experience with octreotide LAR in neuroendocrine tumors: A review of current knowledge.
- Long-acting octreotide treatment has no impact on tumor uptake of 99mTc-HYNIC-TOC in patients with neuroendocrine tumors.
- ANNIVERSARY REVIEW: Octreotide, 40 years later.
- Tumor-Directed Therapeutic Targets in Cushing Disease.
- Pasireotide protects mammalian cochlear hair cells from gentamicin ototoxicity by activating the PI3K-Akt pathway.
- Cell specific interaction of pasireotide: review of preclinical studies in somatotroph and corticotroph pituitary cells.
- Pegvisomant Improves Glucose Metabolism in Acromegaly: A Meta-Analysis of Prospective Interventional Studies.
- Effectiveness and safety of pegvisomant: a systematic review and meta-analysis of observational longitudinal studies.
- Biochemical efficacy of long-acting lanreotide depot/Autogel in patients with acromegaly naïve to somatostatin-receptor ligands: analysis of three multicenter clinical trials
- LANREOTIDE THERAPY IN CARCINOID SYNDROME: PROSPECTIVE ANALYSIS OF PATIENT-REPORTED SYMPTOMS IN PATIENTS RESPONSIVE TO PRIOR OCTREOTIDE THERAPY AND PATIENTS NAÏVE TO SOMATOSTATIN ANALOGUE THERAPY IN THE ELECT PHASE 3 STUDY.
- Cost-effectiveness of acromegaly treatments: a systematic review.
- Pasireotide in the treatment of neuroendocrine tumors: a review of the literature.
- Multidisciplinary management of refractory insulinomas.
- The Antiproliferative Role of Lanreotide in Controlling Growth of Neuroendocrine Tumors: A Systematic Review.
- Octreotide use and safety in infants with hyperinsulinism.
- Octreotide Is Ineffective in Treating Tumor-Induced Osteomalacia: Results of a Short-Term Therapy.
- Pasireotide can induce sustained decreases in urinary cortisol and provide clinical benefit in patients with Cushing's disease: results from an open-ended, open-label extension trial
- Medical Therapy with Pasireotide in Recurrent Cushing's Disease: Experience of Patients Treated for At Least 1 Year at a Single Center
- Pasireotide - Mechanism of Action and Clinical Applications
- Diabetes in Cushing Disease.
- The Effect of the Exon-3-Deleted Growth Hormone Receptor on Pegvisomant-Treated Acromegaly: A Systematic Review and Meta-Analysis.
- Pegvisomant: a growth hormone receptor antagonist used in the treatment of acromegaly.
- Pegvisomant-primed growth hormone (GH) stimulation test is useful in identifying true GH deficient children.
- Diabetes in Patients With Acromegaly.
- Lanreotide for the treatment of gastroenteropancreatic neuroendocrine tumors.
- Octreotide and Lanreotide in Gastroenteropancreatic Neuroendocrine Tumors.
- Tumor Growth Rate (TGR) as an Indicator of Antitumor Activity With Lanreotide Autogel/Depot (LAN) Versus Placebo (Pbo) in Intestinal/Pancreatic NET: Post Hoc Analysis of CLARINET Data.
- Anti-tumour effects of lanreotide for pancreatic and intestinal neuroendocrine tumours: the CLARINET open-label extension study.
- Octreotide - A Review of its Use in Treating Neuroendocrine Tumours
- Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies.
- Pasireotide for malignant insulinoma.
- Hyperglycemia in pasireotide-treated patients with acromegaly and its treatment.
- Hyperglycemia induced by pasireotide in patients with Cushing's disease or acromegaly.
- Management of Hyperglycemia in Patients With Acromegaly Treated With Pasireotide LAR.
- Pasireotide induced adrenal insufficiency.
- Lanreotide-conjugated PEG-DSPE micelles: an efficient nanocarrier targeting to somatostatin receptor positive tumors.
- Lanreotide Reduces Liver Volume, But Might Not Improve Muscle Wasting or Weight Loss, in Patients With Symptomatic Polycystic Liver Disease.
- Lanreotide and its Potential Applications in Polycystic Kidney and Liver Diseases.
- Pasireotide in Acromegaly: A Review.
- Safety and efficacy of oral octreotide in acromegaly: results of a multicenter phase III trial
- Octreotide s.c. depot provides sustained octreotide bioavailability and similar IGF-1 suppression to octreotide LAR in healthy volunteers.
- Extended treatment of Cushing's disease with pasireotide: results from a 2-year, Phase II study
- Up-to 5-year efficacy of pasireotide in a patient with Cushing's disease and pre-existing diabetes: literature review and clinical practice considerations.
- Lanreotide in metastatic enteropancreatic neuroendocrine tumors
- Tumor shrinkage with lanreotide Autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial
- Lanreotide autogel(®): a review of its use in the treatment of patients with acromegaly.
- Pasireotide versus continued treatment with octreotide or lanreotide in patients with inadequately controlled acromegaly (PAOLA): a randomised, phase 3 trial.
- Acromegaly clinical trial methodology impact on reported biochemical efficacy rates of somatostatin receptor ligand treatments: a meta-analysis
- Pasireotide versus continued treatment with octreotide or lanreotide in patients with inadequately controlled acromegaly (PAOLA): a randomised, phase 3 trial