New treatments for acromegaly: Is a revolution underway?

The first-line treatment for acromegaly is transsphenoidal surgery. Somatostatin receptor ligands are usually prescribed if surgery fails, or, in some patients, as pre-surgical medical treatment. The efficacy and tolerance of first-generation somatostatin receptor ligands is well established, but they incur unmet medical needs due to their mode of administration and side effects. We report results for new compounds that may be used in the near future as alternatives to first-generation somatostatin receptor ligands, with data on efficacy and tolerance: oral octreotide, paltusotine and long-acting subcutaneous octreotide are reviewed in detail, together with potential new compounds under investigation. We also discuss their potential role in the therapeutic armamentarium for acromegaly.