title: New therapeutic agents for acromegaly.
abstract: The currently available somatostatin receptor ligands (SRLs) and growth hormone (GH) antagonists are used to control levels of GH and insulin-like growth factor 1 (IGF-1) in patients with acromegaly. However, these therapies are limited by wide variations in efficacy, associated adverse effects and the need for frequent injections. A phase III trial of oral octreotide capsules demonstrated that this treatment can safely sustain suppressed levels of GH and IGF-1 and reduce the severity of symptoms in patients with acromegaly previously controlled by injectable SRL therapy, with the added benefit of no injection-site reactions. Phase I and phase II trials of the pan-selective SRL DG3173, the liquid crystal octreotide depot CAM2029 and an antisense oligonucleotide directed against the GH receptor have shown that these agents can be used to achieve biochemical suppression in acromegaly and have favourable safety profiles. This Review outlines the need for new therapeutic agents for patients with acromegaly, reviews clinical trial data of investigational agents and considers how these therapies might best be integrated into clinical practice.
authors.affiliation: Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Room 2015, Los Angeles, California 90048, USA.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Melmed
mesh_terms: D000236:Adenoma / Q000188:drug therapy* / Q000378:metabolism; D000284:Administration, Oral; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D055785:Gene Knockdown Techniques; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000188:drug therapy* / Q000378:metabolism; D019382:Human Growth Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use; D009841:Oligonucleotides / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000627:therapeutic use; D016372:RNA, Antisense / Q000627:therapeutic use; D011986:Receptors, Somatotropin / Q000235:genetics; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: C511386:ATL 227446; D018931:Antineoplastic Agents, Hormonal; D009841:Oligonucleotides; C420459:PTR 3173; D010456:Peptides, Cyclic; D016372:RNA, Antisense; D011986:Receptors, Somatotropin; C060347:lanreotide; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; C406545:pegvisomant; D015282:Octreotide