Use of Pasireotide in Acromegaly: Clinical Experiences From a Series of Patients in Qatar

Acromegaly, a rare endocrine disorder characterised by excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1), is often due to GH-secreting pituitary adenomas. Pasireotide, a second-generation somatostatin receptor ligand (SRL), binds to multiple somatostatin receptors (SSTRs) and offers a promising alternative for patients unresponsive to first-generation SRLs like octreotide and lanreotide.

This report examines five acromegaly patients treated with pasireotide in Qatar after the failure of a first-generation SRL to normalise IFG-1 levels. Patient 1, a 39-year-old male with hyperprolactinaemi+a and acromegaly who underwent multiple therapies including surgery and radiotherapy, showed tumour size reduction and IGF-1 control with pasireotide. Patient 2, 48-year-old male with a significant macroadenoma and prior cabergoline treatment, achieved partial biochemical control. He developed Type 2 diabetes mellitus, which was managed with metformin/sitagliptin. Patient 3, a 41-year-old male, experienced dramatic symptom resolution and weight loss after switching to pasireotide, significantly improving his quality of life, with a reduction in tumour size. Patient 4, 52-year-old female, despite initial side effects on pasireotide, achieved normalisation in IGF-1 levels and resolution of active symptoms, with a significant reduction in tumour size. Patient 5, a 38-year-old female, after persistent elevation of IGF-1 on octreotide, responded well to pasireotide with a significant reduction in IGF-1. In all five cases switching to pasireotide demonstrated marked efficacy by normalising IGF-1 and eliminating acromegaly symptoms within the first months of treatment. Four out of these five patients showed reduction in tumour size.

This case series corroborates the findings from previous studies, adding insight into treatment challenges and benefits experienced by this heterogeneous group of patients on pasireotide.