Treatment of acromegaly
What is it?
The goal of medical therapy in acromegaly is normalization (or reduction) of hormonal hypersecretion (GH and IGF-I) and resolution of symptoms and systemic complications of the disease. Most drugs are also able to bring about a reduction in tumor mass in the long term.
When is this procedure indicated?
Medical treatment is indicated in all cases of active acromegaly in which surgical treatment has been found to be non-curative, is contraindicated or is refused by the patient. First-choice treatment involves the prescription of first-generation somatostatin analogs (octreotide LAR and lanreotide AGT). If ineffective, second-level somatostatin analogs (pasireotide) or GH receptor antagonists (pegvisomant) may be prescribed.
How is it performed?
Drugs can be taken by subcutaneous or intramuscular injections. Depending on the prescribed molecule, it can be administered every day of the week or once a month.
Contraindications
The most frequent side effects include skin manifestations at the site of injection (rubor, pain, calor, etc.) and, in the case of somatostatin analogues, gastrointestinal symptoms including diarrhea, nausea, intestinal discomfort are reported with some frequency. These symptoms are in the vast majority of patients, more frequent at the start of therapy (but they resolve themselves after a few administrations), are also of mild entity and resolve within a few days after administration.
Where do we treat it?
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