Review
Medicine, General & Internal
Alexandru Dan Popescu, Mara Carsote, Ana Valea, Andreea Gabriela Nicola, Ionela Teodora Dascalu, Tiberiu Tirca, Jaqueline Abdul-Razzak, Mihaela Jana Tuculina
Summary: Acromegaly-related sub/infertility is associated with suboptimal disease control, hyperprolactinemia, hypogonadotropic hypogonadism, and glucose profile anomalies. This review explores the impact of acromegaly on pregnancy outcomes and discusses management strategies. The level of disease control, family history of diabetes, and body mass index are important predictors of maternal complications. Pharmacotherapy has been shown to be safe and effective in improving pregnancy outcomes.
Article
Endocrinology & Metabolism
Sabrina Chiloiro, Antonio Bianchi, Antonella Giampietro, Alfredo Pontecorvi, Gerald Raverot, Laura De Marinis
Summary: This review provides an overview of the second-line therapies for acromegaly, summarizing the evidence on clinical, molecular, and morphological aspects that can predict the response to these treatments and advocating for a patient-tailored therapeutic approach in clinical practice.
BEST PRACTICE & RESEARCH CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Sabrina Chiloiro, Antonella Giampietro, Federica Mirra, Federico Donfrancesco, Tommaso Tartaglione, Pier Paolo Mattogno, Flavia Angelini, Lauretti Liverana, Marco Gessi, Anile Carmelo, Guido Rindi, Andrea Giustina, Maria Fleseriu, Alfredo Pontecorvi, Laura De Marinis, Antonio Bianchi
Summary: The study investigated predictors of response to Pegvisomant and Pasireotide LAR in acromegaly patients, finding that factors such as tumor extension, Ki67-Li levels, and IGF-I levels may impact treatment efficacy.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Andrea Giustina, Luigi di Filippo, Melin M. Uygur, Stefano Frara
Summary: A personalized approach to acromegaly treatment, utilizing novel clinical and molecular biomarkers, has shown promising results in predicting responsiveness to second-line medical treatments. Integrating these findings into existing guidelines may significantly improve the management of difficult acromegaly patients.
Article
Endocrinology & Metabolism
N. Prencipe, C. Bona, D. Cuboni, M. Parasiliti-Caprino, A. M. Berton, L. M. Fenoglio, V. Gasco, E. Ghigo, S. Grottoli
Summary: The study found that biliary adverse events induced by somatostatin receptor ligand therapy are common in acromegaly patients, but many patients are asymptomatic. Early use of ursodeoxycholic acid and adjusting lifestyle can effectively manage these adverse events.
Article
Endocrinology & Metabolism
Marcus Quinkler, David Petroff, Ulrich J. Knappe, Jochen Schopohl, Anke Toenjes, Sebastian M. Schmid
Summary: In German patients with acromegaly, most patients receiving medical therapy have normal or low IGF-1 levels. The majority of patients are treated with somatostatin analogs, with some patients using a combination of different medical regimens. Some patients did not achieve normalization of IGF-1 levels.
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES
(2021)
Article
Endocrinology & Metabolism
Sabrina Chiloiro, Denise Costa, Rosa Lauretta, Valeria Mercuri, Emilia Sbardella, Irene Samperi, Marialuisa Appetecchia, Antonio Bianchi, Antonella Giampietro, Patrizia Gargiulo, Andrea M. Isidori, Maurizio Poggi, Alfredo Pontecorvi, Laura De Marinis
Summary: This study investigated the treatment choices and outcomes for acromegaly patients resistant to first generation somatostatin analogues. The results showed that c-Peg-V and Pasi-Lar were chosen for the treatment of invasive tumors, and partial response to first gen-SSA seemed to be the main determinant for the choice of Pasi-Lar and positively predicted the treatment outcome.
Article
Endocrinology & Metabolism
Thierry Brue, Philippe Chanson, Patrice Rodien, Brigitte Delemer, Delphine Drui, Lucile Marie, Laurene Juban, Lara Salvi, Robin Henocque, Gerald Raverot
Summary: The study aimed to estimate the cost-utility of second-line pharmacological treatments in acromegaly patients.
The incremental cost-utility ratios for pasireotide, pegvisomant, and pegvisomant + FGSA were estimated, showing pasireotide to be the least cost-efficient treatment option.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Maria Fleseriu, Beverly M. K. Biller, Pamela U. Freda, Monica R. Gadelha, Andrea Giustina, Laurence Katznelson, Mark E. Molitch, Susan L. Samson, Christian J. Strasburger, A. J. van der Lely, Shlomo Melmed
Summary: This article focuses on recent advances in the management of acromegaly, emphasizing how key developments affect treatment decisions and outcomes. It also explores the potential role of recently FDA-approved therapies and combination therapies in the treatment arsenal.
Article
Endocrinology & Metabolism
Mirela-Diana Ilie, Antoine Tabarin, Alexandre Vasiljevic, Jean-Francois Bonneville, Lucile Moreau-Grange, Franck Schillo, Brigitte Delemer, Anne Barlier, Dominique Figarella-Branger, Segolene Bisot-Locard, Alexandre Santos, Philippe Chanson, Gerald Raverot
Summary: This study aimed to explore the factors related to SRLs in the treatment of acromegaly and confirmed that SST2A and adenoma granularity are good predictors of response to octreotide. In addition, the optimization of MRI sequences is important for using T2WSI as a predictor of treatment response.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Review
Biochemistry & Molecular Biology
Sofie Eline Tollefsen, Ole Solheim, Patricia Mjones, Sverre Helge Torp
Summary: Meningioma is a common brain tumor without approved specific drugs. This study aims to compile the current insights of somatostatin analogs for treating patients with meningioma. A systematic search was conducted, and 17 eligible studies were evaluated. Although the efficacy of somatostatin analogs remains unclear, some studies suggest that they may be a last-option treatment for severely ill-patients. However, a controlled study or randomized clinical trial is needed to establish their efficacy.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Endocrinology & Metabolism
Amit Akirov, Alexander Gorshtein, Idit Dotan, Nariman Saba Khazen, Yulia Pauker, Michal Gershinsky, Ilan Shimon
Summary: The study shows that pasireotide LAR has tolerable and long-term significant biochemical response in acromegaly patients with potential delayed effect on IGF-1 normalization. Patients with pre-diabetes or diabetes mellitus history have an increased risk of developing new-onset diabetes during treatment with pasireotide.
Article
Endocrinology & Metabolism
G. Corica, R. Pirchio, A. Milioto, F. Nista, A. Arecco, L. Mattioli, R. S. Auriemma, F. Cocchiara, R. Pivonello, A. Colao, D. Ferone, F. Gatto
Summary: Pasireotide therapy has a positive impact on hormonal and glycometabolic outcome in acromegalic patients previously treated with combination medical therapies or unconventional dosages of fg-SRLs. Glucose balance can be maintained through lifestyle interventions and the use of metformin.
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
(2023)
Review
Endocrinology & Metabolism
Maria Fleseriu, Fabienne Langlois, Dawn Shao Ting Lim, Elena V. Varlamov, Shlomo Melmed
Summary: Acromegaly, caused by growth hormone-secreting pituitary adenomas, is usually benign but can be locally invasive and progressive. It leads to a wide range of comorbidities and the normalization of growth hormone and insulin-like growth factor 1 is the primary therapeutic goal. A multimodal approach with surgery, medical therapy, and radiation therapy is required for optimal outcomes.
LANCET DIABETES & ENDOCRINOLOGY
(2022)
Review
Medicine, General & Internal
Amit Akirov, Hiba Masri-Iraqi, Idit Dotan, Ilan Shimon
Summary: The diagnosis, management, and treatment of acromegaly heavily rely on the levels of serum IGF-1, basal GH, and nadir GH following OGTT. However, these hormone concentrations can be influenced by various factors, leading to discordant levels that may require additional monitoring and data. New standards for GH and IGF-1 provide more accurate tools, but limitations should be considered along with clinical history and imaging studies when evaluating patients with acromegaly.
JOURNAL OF CLINICAL MEDICINE
(2021)