Management of acromegaly depends on getting an early diagnosis, proper monitoring, and treatment. This section will highlight what you need to know about this process, including:
- Therapy options
- Monitoring acromegaly
Therapy options
The goals of medical treatment in acromegaly are to control growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels, tumor size, and the symptoms of the disease. The American Association of Clinical Endocrinologists recommends the following 2 treatment options for acromegaly1,2:
Surgery
- Surgery is usually the first line of treatment for acromegaly
- The goal of surgery is to remove the tumor to normalize GH and IGF-1 levels
- In some cases, surgery is not possible or all of the tumor cannot be removed
If you are not a candidate for surgery or if surgery has not been curative, your doctor may consider other therapies.
Medical therapy
Somatostatin is a naturally occurring hormone in the body that signals the pituitary gland to stop the overproduction of GH. When you have a pituitary tumor, too much GH is released into the body, and it may be medically necessary to support your body's natural production of somatostatin. This can be regulated by medical treatment with a somatostatin analogue.3,4
Somatostatin analogues3,4:
- Somatostatin analogues work directly at the site of the pituitary tumor by shutting off the production of GH, which causes the symptoms of acromegaly
- For over 10 years, Sandostatin® LAR Depot (octreotide acetate for injectable suspension) has demonstrated unparalleled evidence in acromegaly and has been a trusted medical therapy5,6
- It is a long-acting, monthly injection
Monitoring acromegaly
Your healthcare team monitors your condition so that therapy is as effective as possible. They will regularly order tests to measure the levels of GH and IGF-1 in your blood.
If you are a candidate for surgery, GH and IGF-1 tests are ordered after the tumor is surgically removed to determine whether the tumor has been fully extracted. If some tumor remains, you might be placed on a drug therapy and monitored regularly to keep track of your hormone levels. Even after successful surgery, pituitary tumors have been reported to grow back in up to 14% of patients. It is important for you to follow up with your healthcare team to have GH and IGF-1 levels monitored regularly.
How GH is measured3,7:
- A single measurement of GH provides only limited information because your pituitary gland releases GH in short spurts throughout the day and night. You may, therefore, have a series of GH blood tests, or you may have blood taken for GH levels after a night without food and an early morning drink of an extremely sweet solution. This is called an oral glucose tolerance test (OGTT)
How IGF-1 is measured3,7:
- Because IGF-1 is released more evenly than GH, and these levels remain higher longer, IGF-1 levels can be taken at any time, with a blood test
Sandostatin® LAR Depot (octreotide acetate for injectable suspension) is indicated for long-term maintenance therapy in acromegalic patients who have had an inadequate response to surgery and/or radiotherapy, or for whom surgery and/or radiotherapy is not an option. The goal of treatment in acromegaly is to reduce GH and IGF-1 levels to normal.
Important Safety Information:
As with immediate release Sandostatin® Injection, the most frequently reported drug-related adverse events were biliary disorders (52%), gastrointestinal disorders (7% to 36%), and injection-site pain (2% to 11%). Hypoglycemia (2%), hyperglycemia (15%), and hypothyroidism (2%) have been reported. While not measured in acromegalic patients receiving Sandostatin® LAR Depot, ECG changes have been reported in patients receiving immediate release Sandostatin® Injection; the degree to which these abnormalities are related to octreotide acetate is not clear, as many acromegalics have cardiovascular disease. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
