Abstract
BACKGROUND: 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. CASE SERIES: 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. CONCLUSION: 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.