At this time, treatment options for patients with acromegaly include surgery, medication and radiation, or a combination of these. The decision about which option to start with is usually based on age, the size and location of the tumor, and other existing medical conditions.
- Surgery: The first line of treatment for most patients is surgery to remove the pituitary tumor. If successful, removal of the tumor can quickly and effectively return growth hormone levels to normal. The success of the pituitary surgery depends on the size of the tumor and the patient’s growth hormone levels.
- Medication: If surgery does not return growth hormone levels to normal, or if surgery is not an option, medication may help reduce growth hormone levels. The most common medication for acromegaly is a group of drugs known as somatostatin receptor ligands, or SRLs. Currently, there are three long-acting injectable SRLs (octreotide LAR, lanreotide depot, and pasireotide LAR) and one short-acting injectable SRL (three-times-a-day octreotide) on the market. The long-acting injections typically require a monthly doctor’s office visit for administration. Some patients may also be prescribed a growth hormone receptor antagonist (pegvisomant) or dopamine agonist (bromocriptine or cabergoline).
- Radiation: In some cases, when surgery and medication are not effective in lowering growth hormone levels, radiation may be recommended. Radiation can stop the tumor from growing and slowly lower growth hormone levels.
The current standard-of-care for chronic disease management of acromegaly carries significant treatment and emotional burdens for patients, due to injection-site reactions, suboptimal symptom control and quality-of-life factors1.
- 70 percent of patients experience pain during injection, and half of these suffer continuing injection-site pain days later. Injection-site reactions include hardness, nodules, swelling, bruising and inflammation.
- Approximately half of the patients report symptom breakthrough or treatment wear-off towards the end of the monthly cycle. One-third complain of ongoing symptoms.
- Approximately one-third of patients feel a loss of independence due to the chronic injections, as most patients require a doctor, nurse or caregiver to administer the injection intramuscularly.
In today’s world with limited injectables-only treatment options, there is an unmet need for people living with acromegaly who seek alternative management strategies that can enable them to lead a less disrupted life.
1 Strasburger et al. Patient reported outcomes of parenteral somatostatin analogue injections in 195 patients with acromegaly. Eur J Endocrinol. 2016 Mar;174(3):355-62