Acromegaly: presurgical somatostatin analogs boost short-term cure rate

  • Yang C & al.
  • Sci Rep
  • 01/10/2019

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Preoperative somatostatin analogs (SSAs) are associated with good safety and an improved short-term cure rate in patients with acromegaly receiving transsphenoidal surgery.

Why this matters

  • The role of preoperative SSAs in this patient group is controversial.

Key results

  • Patients who received SSAs had an improved short-term biochemical remission rate compared with those who did not receive SSAs (50.5% vs 35.1%; OR, 2.07; P<.00001 studies patients style="list-style-type:circle;">
  • 44.2% vs 15.6% (OR, 4.33; P=.005) for invasive macroadenomas (2 studies, 88 patients).
  • SSAs were not significantly associated with an improved long-term biochemical remission rate (65.8% vs 54.9%; OR, 1.49; P=.08; 5 studies, 397 patients).
  • SSAs were not associated with increased risk of postoperative complication (12.2% vs 11.1%; OR, 1.14; P=.67; 5 studies, 393 patients).
  • Study design

    • 12 studies (5 randomized controlled trials, 2 prospective studies, and 5 retrospective studies) were included in the meta-analysis.
    • Of 924 patients with acromegaly undergoing surgery, 445 received preoperative SSAs and 479 did not.
    • Funding: None disclosed.

    Limitations

    • Heterogeneity between included studies.
    • Potential selection bias in some included studies.