Clinical case of the use of the long-acting somatostatin analogue in a patient with acromegaly who has not achieved clinical and laboratory remission after telegrammatherapy

Background. The duration of an increase in the growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels directly correlate with the mortality rates in acromegaly that’s why complete biochemical remission of this disease remains the treatment goal. Description of the clinical case. Clinical observation of 38-year-old patient L. is presented The diagnosis of «acromegaly» was established in 2007 (at the age of 27 years), and a course of telegrammatherapy was conducted. From 2008 to 2009, he received a short-acting octreotide analogue, from 2010 to 2016 - a prolonged somatostatin analogue, with pronounced improvement in general condition, but without achievement of laboratory remission. Since 2016, he receives long-acting somatostatin analogue. In the spring of 2018, he was admitted to the hospital for the assessment of the effectiveness of therapy and examination for the detection of complications. Clinical and laboratory compensation of the disease was revealed, and therefore it was recommended to continue drug therapy in the same regimen. Conclusion. Against the background of therapy with long-acting somatostatin analogue, patient with acromegaly achieved clinical and laboratory remission (GH <2.5 ng/ml, IGF-1 - within the reference range), thus, the stabilization of the disease can be expected. Since acromegaly, regardless of the activity of the process, serves as a factor that increases the cardiovascular risk significantly, all patients with this disease must be monitored by a cardiologist with the timely prescription of HMG-CoA reductase inhibitors (statins), if necessary.

acromegaly, pituitary tumor, growth hormone, insulin-like growth factor-1, somatostatin analogs, octreotide