title: Current and future medical treatments for patients with acromegaly.
abstract: BACKGROUND
  Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled.
  
  
  METHODS
  In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide.
  
  
  CONCLUSIONS
  This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.
authors.affiliation: a Chair of Endocrinology , University of Brescia , Brescia , Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Maffezzoni
authors.affiliation: a Chair of Endocrinology , University of Brescia , Brescia , Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Formenti
authors.affiliation: a Chair of Endocrinology , University of Brescia , Brescia , Italy.
authors.forename: Gherardo
authors.initials: G
authors.lastname: Mazziotti
authors.affiliation: a Chair of Endocrinology , University of Brescia , Brescia , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Frara
authors.affiliation: a Chair of Endocrinology , University of Brescia , Brescia , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Giustina
mesh_terms: D000172:Acromegaly / Q000188:drug therapy* / Q000532:radiotherapy; D001905:Botulinum Toxins / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015282:Octreotide / Q000627:therapeutic use; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use; D017481:Receptors, Somatostatin / Q000819:agonists / Q000037:antagonists & inhibitors / Q000378:metabolism; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D018491:Dopamine Agonists; D016376:Oligonucleotides, Antisense; D017481:Receptors, Somatostatin; D011993:Recombinant Fusion Proteins; C585484:SXN101959; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; C517782:pasireotide; D001905:Botulinum Toxins; C406545:pegvisomant; D015282:Octreotide
keywords: Acromegaly; GH; IGF-1; antisense molecules; pegvisomant; somatostatin analogs; somatostatin receptor subtypes