Clinical and biological determinants of short and long term responses to somatostatin analogue therapy in acromegaly patients.

PURPOSE: This study investigated the impact of preoperative clinical/biochemical factors and postoperative adenoma granulation patterns on short and long term responses to somatostatin analogue (SSA) therapy in acromegaly patients.

METHODS

Sixty patients who did not achieve remission after initial surgery were included. Thirty achieved biochemical control at 1 year, while 30 did not respond to first-line SSA therapy.

RESULTS

Hypointense adenomas on preoperative T2-weighted MRI were significantly associated with biochemical remission at 3 months and 1 year (70.6% and 53.3%, respectively; p = 0.001). Patients with diabetes at the time of diagnosis had lower response rates (6.7% vs. 21.6%, 11.7% vs. 38.3%; p = 0.102 and p = 0.008). Those with both diabetes and sparsely granulated adenomas were 5.867 times more likely to not have remission at 1 year (p = 0.041). Baseline GH and IGF-1 levels were not significantly predictive of treatment response (p > 0.05).

CONCLUSION

In acromegaly patients not cured by surgery, hyperintense MRI features, sparse granulation, and diabetes at diagnosis predict reduced short and long term responses to SSA therapy.