Abstract
Acromegaly is a chronic disease that often requires long-term medical treatment. The main group of drugs for acromegaly consists of the first-generation somatostatin analogues such as octreotide and lanreotide. It is also possible to use the dopamine receptor agonist cabergoline. Since 2018, one more growth hormone antagonist, pegvisomant, has been registered in Russia. The goal of drug therapy is to normalize the level of insulin-like growth factor 1, so it is fundamentally important to monitor this indicator. If the level of insulin-like growth factor 1 does not normalize during the use of octreotide or lanreotide in maximum doses for 3–12 months, it is necessary to optimize therapy. In the case of complete resistance to somatostatin analogues, it is possible to switch to pegvisomant, as well as active neurosurgical and/or radio surgical intervention. In case of partial resistance, the use of combination therapy with somatostatin analogues and cabergoline/pegvisomant is justified. The article discusses and justifies various options for optimizing the drug treatment of acromegaly.
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