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.