Endocrine Abstracts

Introduction: The purpose of this study was to evaluate and compare disease outcomes in patients with acromegaly receiving first-line and second-line (after transphenoidal surgery) somatostatin analogs (SSA) treatment.

Methods: The study involved retrospective data collection from charts of 49 patients with acromegaly who were consulted by an endocrinologist in Vilnius University Hospital Santariskiu klinikos between 2007 and 2013.

Results: Patient population consisted of 16 males (32.7%) and 33 (67.3%) females (mean age at diagnosis 54±13 years). Primary SSA therapy was administered in 14 (28.6%) patients who refused or had contraindications to surgical treatment. Transsphenoidal operation was applied as the first-line therapy in 31 (63.3%) patients and led to disease remission in 16 (51.6%) of them. Of surgically treated patients, 15 (48.4%) were diagnosed with desease recurrence and received second-line SSA therapy. Based on the latest GH and IGF-1 results, control and partial control were achieved in 4 (28.6%) and 5 (35.7%) patients in first-line SSA therapy group, and in 7 (46.7%) and 4 (26.7%) patients in second-line SSA therapy group. 5 (35.7%) and 4 (26.7%) of patients in first-line and second-line SSA treatment groups remained uncontrolled. Although we observed higher mean observational period IGF-1 in the first-line SSA treatment group (511.0 (230.9; 791.1) μg/l) as compared to second-line SSA therapy group (403.3 (280.3; 526.2) μg/l), the difference was not statistically significant (P=0.384).

Conclusions: SSAs are more effective in the treatment of acromegaly when applied after transphenoidal surgery, as they help to achieve control of the disease in a greater percentage of patients. Control of the disease remains a challenge despite availability of high-dose SSA treatment as 27–36% of patients receiving primary or second-line SSA treatment remain uncontrolled.