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Table 1 Characteristics of included trials

From: Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

Author, year

Study Design

No. of Patients (Male/Female)

Age (y)

Mean ± SD or Range

Baseline IGF-1 level (μg*L−1)

Mean ± SD

Previous Treatment (n)

Mean or Median dosages of SAs and PEG

Outcomes

Duration of SAs and PEG treatment

Duration of Study/months

Jorgensen, 2005 [29]

Non-controlled, Prospective

11 (7/4)

23–71

269 ± 29

Surgery (9), Radiotherapy (5), SAs(10)

Octreotide: 30 mg/2–4 weeks

PEG: 15 mg/day

IGF-1 levels, GH levels, FPG, FPI, 2-h plasma glucose value

Octreotide: not reported

PEG: 12 weeks

8

Neggers, 2008 [23]

Placebo-controlled, Crossover, Prospective

20 (11/9)

39–74

187.5 ± 35

Both surgery and radiotherapy (6), Surgery (15), Primary medical therapy (5)

SAs: Not reported

PEG: 40 mg/week

IGF-1 levels, glycosylated hemoglobin, FPG, TC, low-density lipoprotein, TELETs, Patient-Assessed Acromegaly Symptom

Questionnaire, Acromegaly Quality of Life Questionnaire

SAs: 32 weeks

PEG: 32 weeks

9

Trainer, 2009 [22]

RCT

84 (44/40)

24–70

626.477 ± 49

Surgery, Octreotide

Octreotide: 30 mg/28 days

PEG: 15 mg/day

IGF-1 levels, acromegaly signs and symptoms, The Acromegaly Quality of Life Questionnaire, Euro Quality of Life-5 Dimensions Questionnaires, Glycaemic control, adverse event

Octreotide: 44 weeks

PEG: 40 weeks

10

Madsen, 2011 [24]

RCT

18 (7/11)

54.2 ± 10.9

Not reported

Surgery (14), Radiotherapy (2), SAs (18)

Octreotide: 6.7-20 mg/28 days

Lanreotide: 24-60 mg/28 days

PEG: 52.5 mg/week

IGF-1 levels, GH levels, 2-h glucose, FPG, FPI, Insulin sensitivity and substrate metabolism, Quality of life, Adverse effects

SAs: 24 weeks

PEG: 24 weeks

6

Van der Lely, 2011 [27]

Non-controlled, Prospective

57 (29/28)

51.6 ± 12.7

Not reported

Surgery (38), Radiotherapy (18), SAs (44), Lanreotide (24), Octreotide (20), PEG (13)

Lanreotide: 120 mg/months

PEG: 60 mg/week

IGF-1 levels, acromegaly symptoms, Acromegaly Quality of Life Questionnaire, glucose tolerance, electrocardiograms, hepatic function tests, standard hematological, biochemical laboratory tests

Lanreotide: 44 weeks

PEG: 28 weeks

7

Colao, 2019 [25]

Longitudinal, Comparative, Prospective

31 (14/17)

44.6 ± 10.5

643

SAs

Lanreotide: 40 mg/28 days

PEG: 70 mg/week

Biochemical control rate, Acromegaly-related clinical signs and symptoms, Health-related quality of life, Safety

SAs: 8 months

PEG: 4 months

8

Muhammad, 2018 [26]

Follow-up, Prospective

30

53

Not reported

Surgery, Radiotherapy, SAs

Pasireotide: 60 mg/28dyas

PEG: 64 mg/week

Percentage of responders, Percentage of patients who stop PEG after 48 weeks, Percentage cumulative PEG dose reduction, Safety

Pasireotide: 36 weeks

PEG: 48 weeks

12

Auriemma, 2016 [28]

Non-controlled, Prospective

36 (14/22)

52.3 ± 10.2

703.6 ± 258.3

Surgery, Radiotherapy, Octreotide (11), Lanreotide (25)

Octreotide: 30 mg/28 days

Lanreotide: 120 mg/28 days

PEG: 100 mg/week

IGF-1levels, cardiovascular parameters, glucose and lipid levels, tumor volume

SAs: 114 months

PEG: 78 months

78

Urbani, 2013 [2]

Non-controlled, Prospective

31 (15/16)

46.47 ± 2.33

Not reported

SAs (31)

Octreotide: 27.50 mg/28 days

Lanreotide: 120 mg/28 days

PEG: 16.9 mg/day

IGF-1 index, GH, Glucose metabolism

SAs: not reported

PEG: not reported

48

  1. RCT randomized controlled trial, SAs somatostatin analogues, IGF-1 insulin-like growth factor 1, GH growth hormone, TC total cholesterol, TELETs transient elevated liver enzyme tests