ABSTRACT
Although transsphenoidal surgery of pituitary micro-or macroadenomas is the treatment of choice in most acromegalic patients, somatostatin analogs are the first choice for medical treatment, either primary or secondary. Nowadays, two forms of octreotide, s.c. short-and i.m. long-acting, and two depot preparations of lanreotide, i.m. slow-repeatable and s.c.autogel, are available. Suppression of GH hypersecretion, lowering IGF-I production, and symptom control, including headache, soft tissue swelling, arthralgia, carpal tunnel syn drome, snoring, sweating and fatigue, are established benefits of the therapy. Metabolic (insu lin resistance, hypertriglyceridemia and hypertension), respiratory and cardiac profiles may also improve during somatostatin analogs treatment. In addition, clinically significant tumor shrinkage has been shown in a number of studies, especially in naive patients although the different radiological techniques and criteria of tumor shrinkage used by the authors are not always comparable. Pain at the injection site, cholesterol gallstone development, abdominal pain, diarrhea, fat malabsorption, nausea and flatulence are the main side effects of these drugs. This review summarizes current knowledge of the effects of somatostatin analogs in the treat ment of acromegaly.
