====== Octreotide for Acromegaly ======

[[Octreotide]] is the only analog currently available for clinical use in the treatment of [[acromegaly]] in the [[United States]]. [[Lanreotide]] has been used extensively in Europe for the treatment of acromegaly.

Octreotide is 45 times more potent at suppressing pituitary GH secretion than native somatostatin-14
((Bauer W, Briner U, Doepfner W, Haller R, Huguenin R, Marbach P, Petcher TJ, Pless. SMS 201-995: a very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci. 1982 Sep 13;31(11):1133-40. doi: 10.1016/0024-3205(82)90087-x. PMID: 6128648.)).
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Octreotide is a mature drug with a consolidated favorable benefit versus risks profile in the treatment of acromegaly
((Giustina A, Karamouzis I, Patelli I, Mazziotti G. Octreotide for acromegaly treatment: a reappraisal. Expert Opin Pharmacother. 2013 Dec;14(17):2433-47. doi: 10.1517/14656566.2013.847090. Epub 2013 Oct 14. PMID: 24124691.)).

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Using standard benchmarks for cost-effectiveness in the US ($100,000/QALY), preoperative octreotide therapy followed by surgery may not be cost-effective compared to direct surgery for patients with growth-hormone secreting pituitary neuroendocrine tumors but the result is highly sensitive to initial treatment failure and duration of preoperative treatment
((Caulley L, Krijkamp E, Doyle MA, Thavorn K, Alkherayf F, Sahlollbey N, Dong SX, Quinn J, Johnson-Obaseki S, Schramm D, Kilty SJ, Hunink MGM. Cost-effectiveness of direct surgery versus preoperative octreotide therapy for growth-hormone secreting pituitary neuroendocrine tumors. Pituitary. 2022 Aug 27. doi: 10.1007/s11102-022-01270-8. Epub ahead of print. PMID: 36030360.))