title: Adverse events associated with somatostatin analogs in acromegaly.
abstract: BACKGROUND
  In patients with acromegaly, somatostatin analogs (SSA) represent the first choice medical treatment. The long-acting SSA have been found to be effective in controlling growth hormone and IGF-I levels in a high percentage of patients, resulting in an improvement in the quality of life; moreover, these peptide analogs have a proven safety record and are generally well tolerated.
  
  
  METHODS
  The most commonly reported adverse events include injection-site discomfort and erythema, gastrointestinal (GI) disturbances such as diarrhea, abdominal pain, nausea and vomiting, biliary sludge or gallstones, and abnormal glucose metabolism. Most SSA-related adverse events are transient and of mild-to-moderate intensity, and the prevalence of such effects markedly and progressively decreases during treatment, so that treatment discontinuations due to adverse events are rare and commonly related to GI disturbances. Cholelithiasis represents the most serious complication of SSA, but is generally asymptomatic, and has been reported in 3 - 56% of patients. Whereas the effect of SSA on glucose metabolism is still controversial, several pieces of evidence have confirmed a modest and transient negative impact on glucose homeostasis. Also the novel SSA pasireotide has shown a safety profile as expected for a SSA, except for the degree of hyperglycemia.
  
  
  CONCLUSIONS
  On the basis of these findings, a close and careful monitoring of gallbladder ultrasound and glucose levels is recommended in patients receiving SSA for medical treatment of acromegaly.
authors.affiliation: University 'Federico II', Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , via S. Pansini 5, 80131 Napoli , Italy +39 081 7462132 ; +39 081 5465443 ; colao@unina.it.
authors.forename: Ludovica F S
authors.initials: LF
authors.lastname: Grasso
authors.forename: Renata S
authors.initials: RS
authors.lastname: Auriemma
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000818:Animals; D016903:Drug Monitoring / Q000379:methods; D005947:Glucose / Q000378:metabolism; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D011788:Quality of Life; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; C517782:pasireotide; D005947:Glucose
keywords: acromegaly; medical therapy; somatostatin analogs