Medical Therapies for Acromegaly

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Medical Therapies for Acromegaly 

  1. Somatostatin Analogues (SSAs)

    • Drugs: Octreotide, Lanreotide, Pasireotide

    • Mechanism: Mimic natural somatostatin to inhibit growth hormone (GH) secretion from the pituitary gland.

    • Use: First-line medical therapy when surgery is not fully effective or feasible.

    • Effect: Reduces GH and IGF-1 levels, shrinks pituitary tumors in some patients.

  2. Growth Hormone Receptor Antagonist

    • Drug: Pegvisomant

    • Mechanism: Blocks GH action at its receptor, preventing IGF-1 production in the liver.

    • Use: Particularly effective in normalizing IGF-1 levels even when GH remains high.

    • Effect: Controls symptoms and metabolic complications but does not shrink the tumor.

  3. Dopamine Agonists

    • Drugs: Cabergoline, Bromocriptine

    • Mechanism: Stimulate dopamine receptors, reducing GH secretion in some patients.

    • Use: Often in mild cases or combined with SSAs for better control.

    • Effect: Less potent than SSAs, but oral administration makes them convenient.

  4. Combination Therapies

    • Approach: Use of SSAs + Pegvisomant or SSAs + Dopamine agonists.

    • Benefit: Improves control of GH/IGF-1 levels when single-drug therapy is insufficient.

  5. Other Emerging Therapies

    • Research focuses on new somatostatin receptor ligands, precision medicine approaches, and long-acting formulations to improve patient compliance and outcomes.

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