Endocrine Abstracts

Currently, acromegaly is treatable by 3 groups of drugs available for the treatment of acromegaly: dopamine agonists (DA), somatostatin analogues (SRL) and a growth hormone receptor blocker (GH receptor antagonist GHRA). More recently, pasireotide and pasireotide-LAR were developed as multi-receptor targeted SRLs with higher potency than 1st generation SRLs/octreotide-LAR and lanreotide/and until now were considered second generation SRLs. Pasireotide, unlike first-generation SRLs, has good affinity for both SST2 and SST5. One of the pasireotide monotherapy groups are non-diabetic patients sufficiently controlled for 1st-generation SRL therapy in combination with low-dose pegvisomant. Pasireotide can also be used in combination with pegvisomant, if the combination of drugs does not sufficiently control the biochemical activity or symptoms of the disease. Short-acting pasireotide demonstrated tumor reduction of at least 20% in 56% of patients after 6 months of treatment. Pasireotide-LAR shows a good tolerability profile, like SRL. The worsening of acromegaly symptoms has been reported to be better with pasireotide than with first-generation SRLs. Hyperglycemia is seen as one limiting factor for its use in acromegaly and Cushing’s disease, especially in diabetic or prediabetic patients at the beginning of treatment. However, all that is achieved is that glycemic control is achieved with good standard antidiabetic treatment, only a small proportion of patients require interruption of treatment and hyperglycemia is induced after the end of reversible treatment. In this abstract we share our experiences with pasireoitde treatment in 5 acromegaly subjects. Overall, it could be assessed that pasireotide treatment is sufficiently effective in inducing biochemical control and at the same time a safe treatment modality in terms of adverse effects and hyperglycemia.