Efficacy and safety of pharmacologic therapies in acromegaly: a systematic literature review and network meta-analysis
Authors' conclusion
This systematic review and NMA consolidate recent high-quality RCT evidence for acromegaly treatments. Paltusotine emerges as a promising alternative to injectable SRLs, with favorable efficacy, safety, and AE-related discontinuation patterns. These findings may inform clinical decision-making and guideline development, if confirmed by clinical experience.
Study context
- Population
- Randomized controlled trials (RCTs) of acromegaly therapies (MEDLINE and Embase)18 RCTs
- Comparison
- Pharmacological treatments for acromegaly
- Outcome
- Biochemical control
Methodological detailsBayesian network meta-analysis (NMA), PRISMA
- Bayesian NMA
- PRISMA
Pooled result
As reported in the abstract
Odds ratio (95% CrI)
Paltusotinevs O-OCT
7.34(1.48–36.07)
Paltusotinevs SC-OCT-D
7.85(1.72–36.25)
Pasireotidevs OCT-LAR
2.03(1.29–3.23)
Further pooled results
Treatment ranking
- Paltusotine had the highest probability of ranking most effective (or tolerable) across all endpoints
Safety
| Outcome | OR (CrI) | |
|---|---|---|
| Discontinuations due to AEsPaltusotinevs O-OCT | 0.022 (0.001–0.424) | |
| Discontinuations due to AEsPaltusotinevs SC-OCT-D | 0.022 (0.001–0.343) | |
| 0.050.21520Odds ratio (log scale) |
Discontinuations due to adverse events (AEs)
- Paltusotine similar rates to other treatments
Treatment-emergent AEs (TEAEs) and serious TEAEs
- Comparable across treatments
Original publication
Efficacy and safety of pharmacologic therapies in acromegaly: a systematic literature review and network meta-analysis. J Clin Endocrinol Metab. Published 3 March 2026. doi:10.
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