Update on the use of oral octreotide therapy for acromegaly

ABSTRACT

Introduction: Somatostatin analogs are most commonly used in pharmacological treatment of acromegaly. Pegvisomant and dopamine agonists are alternatives, which are used to a lesser extent. Dopamine agonists are the only orally applicable medication but are less effective than the other options. For a large number of patients, life-long pharmacotherapy has to be applied and frequent injections represent a reduction of quality of life for many of them.

Areas covered: Recently published evidence for the use of oral octreotide therapy for acromegaly.

Expert commentary: Oral octreotide is a novel and effective treatment for acromegaly and the side effects have been shown to be comparable to the injectable SSAs. The combination with a transient permeability enhancer allows intestinal permeation but also enables molecules with a size <70 kDa to pass transiently. This does not seem to have an acute or subacute consequence, but the long-term effect is still elusive. Therefore, more long-term trials are desirable.

KEYWORDS:

• Oral octreotide
• octreolin
• acromegaly
• somatostatin analog
• pituitary adenoma
• growth hormone
• transient permeability enhancer (TPE)

Declaration of interest

J. Schopohl participated in the phase III study (Protocol # CH-ACM-01), entitled ‘Efficacy and safety of oral octreolin in Patients with acromegaly who are currently receiving parenteral somatostatin analogs’. J. Schopohl received grants from Chiasma, Ipsen, Novartis and Pfizer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.