Acromegaly is a disease characterized by
growth hormone (GH) excess originating, in approximately 95% of cases, from a somatotroph
pituitary adenoma. Symptomatology and clinical features are due to GH and
insulin-like growth factor 1 excess; unfortunately, for most patients diagnosis is delayed by several years.
Acromegaly patients' morbidity and mortality are higher than those of the normal population. However, with adequate biochemical control mortality rates can be restored to normal.
Tumor size and location, symptoms, comorbidities, and lastly, but not least, patient preference, are all important aspects in treatment decision making, and treatment approach should be individualized. Current
therapy includes medical, surgical, and radiation. This review focuses on recent significant developments in medical
therapy. There are three major therapeutic
drug classes:
somatostatin receptor ligands (SRLs), which represent the mainstay of medical
therapy, GH receptor blockers, and
dopamine agonists. Multi-
ligand receptor SRLs such as
pasireotide, should increase therapeutic choices for
acromegaly patients currently uncontrolled on available SRLs. Furthermore, significant research has been focused in the development of novel delivery modalities (e.g., oral and long acting subcutaneous administration).