Background: The aim of this study was to evaluate the outcomes of medical treatment in patients with active acromegaly.
Material and Methods: We performed a retrospective analysis of 163 patients (101 female, age at diagnosis 47.2±13.4 years) treated between 1990 and 2020., of which 53 were on medical treatment (32.5%). Remission rate after pituitary surgery was 66.5% (n=105/158; 5 patients refused surgery). Patients who did not achieve remission and with relapse (n=2) underwent another surgery (n=18/60, 30%) and/or radiotherapy (n=33/60, 55%) and/or medical treatment (n=53/60, 88.3%). One patient refused further treatment after failed first pituitary surgery. The duration of follow-up was 115.8±304.4 months.
Results: Out of 53 patients on medical treatment, during follow-up monotherapy was used in 34 (64.2%) and combination therapy in 19 (35.8%) patients. Remission (IGF-1 < 1.2 ULN) was achieved in 51 patients (96.2%); in 21/53 (39.6%) with first generation somatostatin analogue (SSA-1) monotherapy, in 10/53 (18.9%) with dopamine agonist (DA) monotherapy, in one (1.9%) with pegvisomant monotherapy, in 13/53 (24.4%) with combination of SSA-1 and DA, in three (5.7%) with combination of SSA-1, DA and pegvisomant, in two (3.8%) patients with combination of SSA-2, DA and pegvisomant and in one (1.9%) after adding temozolomide on top of SSA-1 and DA. Two patients currently have active disease, both on SSA-1 monotherapy, of whom one is non-adherent to the tratment.
Conclusion: Our results indicate that medical treatment, when combined appropriately, can lead to biochemical remission in almost all patients with acromegaly.
21 May 2022 - 24 May 2022