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Efficacy and safety of somatostatin anologues and trans-sphenoidal surgery in the treatment of acromegaly

Grant number: 11/20517-2
Support Opportunities:Regular Research Grants
Duration: July 01, 2012 - June 30, 2014
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Vania dos Santos Nunes Nogueira
Grantee:Vania dos Santos Nunes Nogueira
Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
Associated researchers:Celia Regina Nogueira ; Cesar Luiz Boguszewski ; Marco Antônio Zanini


Among the treatment options for Acromegaly, trans-sphenoidal surgery is the first option in most cases. However, most patients have invasive tumors at diagnosis, with a low chance of surgical cure, so most end up getting the somatostatin analogue (SA) as a complementary treatment. Previous studies comparing the trans-sphenoidal surgery versus the SA as a primary treatment of this neoplasia have showed controversial results. It has also been studied whether the SA given before surgery may improve the final surgical outcome, but there is no evidence in this regard. When comparing octreotide versus lanreotide, both seem to be effective in treating additional surgery. However, there aren't systematic reviews involving these topics, and the principal existing studies took into account the old criteria for Acromegaly cure (basal GH <2.5 ng / mL and normal IGF1). This study will evaluate the efficacy and safety of SAs and trans-sphenoidal surgery in the treatment of Acromegaly, comparing: (a) surgery versus surgery preceded by SA and (b) the SAs each other. In all these sub-items will be compared the results with the old criteria for cure versus the current (basal GH <1 ng / mL and normal IGF1). For this, there will be a systematic literature review according to Cochrane methodology. When the data from more than one study are homogeneous and with their similar clinical outcomes, they will be plotted in a meta-analysis. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
NUNES, V. S.; CORREA, J. M. S.; PUGA, M. E. S.; SILVA, E. M. K.; BOGUSZEWSKI, C. L.. Preoperative somatostatin analogues versus direct transsphenoidal surgery for newly-diagnosed acromegaly patients: a systematic review and meta-analysis using the GRADE system. Pituitary, v. 18, n. 4, p. 500-508, . (11/20517-2)

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