A RISK-BENEFIT ASSESSMENT OF OCTREOTIDE IN THE TREATMENT OF ACROMEGALY

Acromegaly was the first pituitary disease to be recognised as a clini cal entity, although initially it was not clear whether the eosinophil ic adenomas causing pituitary enlargement were causative or just a man ifestation of the syndrome itself. Following the documented clinical i mprovement of patients with acromegaly after partial hypophysectomy, i t was proven that the pituitary adenomas were aetiological. The treatm ent of acromegaly has changed during the last decades; the introductio n of the somatostatin (SMS) analogue octreotide has had major implicat ions. Octreotide was the first SMS analogue to become available for cl inical use. It is generally well tolerated, but is associated with the development of gallstones in 15 to 20% of patients. Other adverse eff ects include transient injection-site pain, abdominal, diarrhoea, gast ritis (long term therapy) and loss of scalp hair. No long haematologic al or biochemical adverse effects have been reported. Desensitisation to the beneficial effects of octreotide therapy is highly unusual. A l ong-acting formulation of octreotide is being studied, and should be a vailable by the end of 1997.