How effective are somatostatin analogues?
Somatostatin analogues markedly decrease GH levels in most patients with acromegaly, with alleviation of many of the symptoms and side effects of acromegaly. Approximately 20% to 35% of patients receiving somatostatin analogues achieve biochemical remission, although additional patients experience symptomatic improvement with partial biochemical responses. Significant tumor shrinkage occurs in approximately 60% of patients. However, these agents do not cure acromegaly; stopping the drug usually leads to increases in GH levels and tumor regrowth. Somatostatin analogues are commonly used indefinitely after surgery has failed to achieve biochemical control of GH hypersecretion. They can also be used before surgery to improve comorbidities, temporarily after surgery while waiting for radiation therapy to take effect (see below), or instead of surgery in carefully selected patients. Common side effects include gastrointestinal symptoms and gallstone formation.