Related Experiment Video
Updated: Jul 8, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Preliminary data on biochemical remission of acromegaly after somatostatin analogs withdrawal
Cristina L Ronchi1, Erica Rizzo, Andrea G Lania
1Unit of Endocrinology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza, 35, 20122 Milan, Italy. cristina.ronchi@unimi.it
Objective:
It is still unknown whether prolonged treatment with somatostatin analogs (SSTa) may cause a long-lasting disease remission in GH-secreting adenomas after drug discontinuation. The aim of the present study was to investigate the evolution of GH/IGF-I secretion and tumor mass after SSTa withdrawal in patients affected by acromegaly.
Patients And Design:
A total of 27 patients with acromegaly (12 de novo and 15 previously operated) were treated with SSTa for a median period of 48 months and considered optimally controlled in hormonal and neuroradiological terms. None of them were previously irradiated.
Methods:
Basal GH, post-glucose GH nadir, IGF-I, clinical signs/symptoms, and metabolic parameters were evaluated after 12-16 weeks from drug withdrawal. Only patients who met the current criteria for disease remission remained in drug suspension being periodically re-evaluated for biochemical/clinical data and neuroradiological imaging.
Results:
After 12-16 weeks withdrawal, 15 of the 27 patients had disease relapse and restarted SSTa, while 12 were considered 'in disease remission' (44% of total). Glucose metabolism improved in both euglycemic and diabetic patients after short-term SSTa discontinuation. Only one of the ten patients who reached 24 weeks withdrawal showed biochemical disease recurrence. On the whole, five of the patients still in remission after 6 months have already prolonged the follow-up over 12 months (median: 24 months), without clinical and biochemical/neuroradiological evidence of disease recurrence.
Conclusions:
These preliminary data indicate a successful withdrawal of SSTa at least in a subset of well-responsive patients with acromegaly and challenge the previously held concept that medical therapy is always a lifelong requirement.
Insights
Discontinuing somatostatin analogs (SSTa) may lead to disease remission in some acromegaly patients. This study found that a subset of well-controlled patients can successfully withdraw from SSTa treatment long-term.
Area of Science:
- Endocrinology
- Oncology
- Pharmacology
Background:
- Acromegaly is caused by GH-secreting adenomas.
- Somatostatin analogs (SSTa) are used to control hormone secretion and tumor size.
- Long-term remission after SSTa discontinuation is not well-established.
Purpose of the Study:
- To investigate sustained remission of GH/IGF-I secretion and tumor mass after SSTa withdrawal in acromegaly patients.
- To assess the feasibility of discontinuing SSTa in optimally controlled patients.
Main Methods:
- 27 acromegaly patients (12 de novo, 15 post-surgery) optimally controlled on SSTa for ≥48 months were included.
- Hormonal levels (GH, IGF-I), clinical status, and tumor imaging were assessed 12-16 weeks post-SSTa withdrawal.
- Patients in remission were monitored for recurrence; those relapsing restarted SSTa.
Main Results:
- 12 out of 27 patients (44%) achieved disease remission after SSTa withdrawal.
- Glucose metabolism improved in patients after short-term SSTa discontinuation.
- Five patients maintained remission for over 12 months (median 24 months) without recurrence.
Conclusions:
- SSTa withdrawal is feasible in a subset of well-controlled acromegaly patients.
- These findings challenge the notion that medical therapy for acromegaly is always lifelong.
- Further research is needed to identify predictors of sustained remission.
