Medical treatment in acromegaly: a network meta-analysis
Authors' conclusion
Our findings suggest pasireotide LAR and pegvisomant as the most effective treatments for IGF-1 normalization. Pasireotide LAR was the best treatment for tumor shrinkage, though the evidence base was limited, requiring cautious interpretation. Their potential role as first-line options after surgery requires further research. Clinical decisions should consider cost, safety, and patient-specific parameters to optimize outcomes.
Study context
- Population
- Patients with acromegaly; studies from PubMed, Scopus and Web of Science up to June 2024
- Participants
- 4,131 patients27 studies
- Comparison
- Medical treatments for acromegaly
- Outcome
- Adjusted IGF-1 normalization (%) and tumor shrinkage
Methodological detailsrandomized controlled trials and nonrandomized studies, PRISMA-NMA and Cochrane Handbook
- Randomized controlled trials and nonrandomized studies
- PRISMA-NMA and Cochrane Handbook
Pooled result
As reported in the abstract
IGF-1 normalization
Odds ratio (95% CI)
Pegvisomantvs First-generation SRLs + dopamine agonistsI2 = 41%
1.83(1.37–2.46)
Pasireotide LARvs First-generation SRLs + dopamine agonistsI2 = 41%
1.46(1.02–2.08)
Octreotide LARvs Oral octreotide capsules
5.41(1.89–15.52)
Pasireotide LARvs SRLsTumor shrinkage; n = 1059; I2 = 0%
11.47(1.5–87.64)
Original publication
Medical treatment in acromegaly: a network meta-analysis. Eur J Endocrinol. Published 27 October 2025. doi:10.
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