Persistent remission of acromegaly in a patient with GH-secreting pituitary adenoma: Effect of treatment with pasireotide long-acting release and consequence of treatment withdrawal

J Clin Pharm Ther. 2022 Jun;47(6):835-840. doi: 10.1111/jcpt.13615. Epub 2022 Feb 15.

Abstract

What is known and objective: Somatostatin analogues (SSAs) have been used for the treatment of acromegaly for several decades. However, a unified conclusion on the duration of SSAs therapy or the possibility of medication withdrawal is still missing. We aimed to report a case of acromegaly cured by pasireotide long-acting release (PAS-LAR) and provide some information on the withdrawal of SSAs after stable regression in acromegalic patients.

Case summary: A 55-year-old male patient, who was diagnosed with acromegaly and refused surgery and received PAS-LAR as initial treatment, had maintained stability for ten years under the regular treatment with PAS-LAR. The pituitary microadenoma was also decreased during the treatment. After the PAS-LAR discontinuation for 21 months, no evidence of biochemical or clinical recurrence was found in this patient.

What is new and conclusion: The use of PAS-LAR in a subset of naive-treatment patients is promising to induce long-term regression. A subgroup of patients with mild and well-controlled acromegaly might hope for perpetual remission after the withdrawal of medication.

Keywords: acromegaly; pasireotide long-acting release; persistent remission; withdrawal.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly* / drug therapy
  • Adenoma* / chemically induced
  • Adenoma* / complications
  • Adenoma* / drug therapy
  • Growth Hormone-Secreting Pituitary Adenoma* / chemically induced
  • Growth Hormone-Secreting Pituitary Adenoma* / complications
  • Growth Hormone-Secreting Pituitary Adenoma* / drug therapy
  • Human Growth Hormone* / therapeutic use
  • Humans
  • Insulin-Like Growth Factor I
  • Male
  • Middle Aged
  • Octreotide
  • Somatostatin / analogs & derivatives
  • Somatostatin / therapeutic use
  • Treatment Outcome

Substances

  • Human Growth Hormone
  • Somatostatin
  • Insulin-Like Growth Factor I
  • pasireotide
  • Octreotide