Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs
Acromegaly is a condition most commonly diagnosed in the fifth decade of life and has numerous treatment options. In this regard, Mycapssa<sup>®</sup> is the first FDA-approved oral octreotide capsule for treating acromegaly, combining the efficacy of the somatostatin receptor ligand, oc...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Pathophysiology |
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| Online Access: | https://www.mdpi.com/1873-149X/30/3/29 |
| _version_ | 1797578087425114112 |
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| author | Charles P. Daniel Maxwell J. Wagner Grant E. Borne Connor J. Plaisance Shahab Ahmadzadeh Alfonso Aquino Sahar Shekoohi Adam M. Kaye Elyse M. Cornett Alan D. Kaye |
| author_facet | Charles P. Daniel Maxwell J. Wagner Grant E. Borne Connor J. Plaisance Shahab Ahmadzadeh Alfonso Aquino Sahar Shekoohi Adam M. Kaye Elyse M. Cornett Alan D. Kaye |
| author_sort | Charles P. Daniel |
| collection | DOAJ |
| description | Acromegaly is a condition most commonly diagnosed in the fifth decade of life and has numerous treatment options. In this regard, Mycapssa<sup>®</sup> is the first FDA-approved oral octreotide capsule for treating acromegaly, combining the efficacy of the somatostatin receptor ligand, octreotide, with the ease of a twice-daily oral capsule. Where surgical treatment is not an option, somatostatin analogs, including octreotide, are the first line of medical treatment for acromegaly, requiring regular subcutaneous or intramuscular injections administered by a patient’s healthcare provider. Octreotide capsules (Mycapssa<sup>®</sup>) provide an alternative to these somatostatin receptor ligand injections by combining octreotide with other excipients to produce a transient permeability enhancer technology that improves paracellular transport of octreotide across the gastrointestinal wall into the small intestine. Across multiple trials, including open-label (CH-ACM-01), double-blind placebo-controlled (CHIASMA OPTIMAL), and open-label extension of the trial period (CHIASMA OPTIMAL OLE), Mycapssa<sup>®</sup> octreotide capsules maintained a consistent biochemical normalization of IGF-1 and GH levels, safety profiles similar to injected somatostatin receptor ligands, and patient preference to continued treatment with octreotide capsules. While clinical trial data supports the use of octreotide capsules (Mycapssa<sup>®</sup>) in the pharmacological management of GH and IGF-1 levels, very little data exist regarding the drug’s efficacy, tolerability, and use in female or pediatric-specific populations. A better understanding of the efficacy, application, and role of oral octreotide capsules in the long-term medical management of acromegaly in a diversity of populations is imperative to best determine the risks/benefits for the clinician. |
| first_indexed | 2024-03-10T22:17:32Z |
| format | Article |
| id | doaj.art-3d30e80ed8d0419daffc92b5f0015eda |
| institution | Directory Open Access Journal |
| issn | 1873-149X |
| language | English |
| last_indexed | 2024-03-10T22:17:32Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathophysiology |
| spelling | doaj.art-3d30e80ed8d0419daffc92b5f0015eda2023-11-19T12:23:25ZengMDPI AGPathophysiology1873-149X2023-09-0130337738810.3390/pathophysiology30030029Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin AnalogsCharles P. Daniel0Maxwell J. Wagner1Grant E. Borne2Connor J. Plaisance3Shahab Ahmadzadeh4Alfonso Aquino5Sahar Shekoohi6Adam M. Kaye7Elyse M. Cornett8Alan D. Kaye9School of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USADepartment of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USADepartments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USAAcromegaly is a condition most commonly diagnosed in the fifth decade of life and has numerous treatment options. In this regard, Mycapssa<sup>®</sup> is the first FDA-approved oral octreotide capsule for treating acromegaly, combining the efficacy of the somatostatin receptor ligand, octreotide, with the ease of a twice-daily oral capsule. Where surgical treatment is not an option, somatostatin analogs, including octreotide, are the first line of medical treatment for acromegaly, requiring regular subcutaneous or intramuscular injections administered by a patient’s healthcare provider. Octreotide capsules (Mycapssa<sup>®</sup>) provide an alternative to these somatostatin receptor ligand injections by combining octreotide with other excipients to produce a transient permeability enhancer technology that improves paracellular transport of octreotide across the gastrointestinal wall into the small intestine. Across multiple trials, including open-label (CH-ACM-01), double-blind placebo-controlled (CHIASMA OPTIMAL), and open-label extension of the trial period (CHIASMA OPTIMAL OLE), Mycapssa<sup>®</sup> octreotide capsules maintained a consistent biochemical normalization of IGF-1 and GH levels, safety profiles similar to injected somatostatin receptor ligands, and patient preference to continued treatment with octreotide capsules. While clinical trial data supports the use of octreotide capsules (Mycapssa<sup>®</sup>) in the pharmacological management of GH and IGF-1 levels, very little data exist regarding the drug’s efficacy, tolerability, and use in female or pediatric-specific populations. A better understanding of the efficacy, application, and role of oral octreotide capsules in the long-term medical management of acromegaly in a diversity of populations is imperative to best determine the risks/benefits for the clinician.https://www.mdpi.com/1873-149X/30/3/29acromegalyMycapssa<sup>®</sup> (oral octreatide)somatostatin analogsgrowth hormoneIGF-1 |
| spellingShingle | Charles P. Daniel Maxwell J. Wagner Grant E. Borne Connor J. Plaisance Shahab Ahmadzadeh Alfonso Aquino Sahar Shekoohi Adam M. Kaye Elyse M. Cornett Alan D. Kaye Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs Pathophysiology acromegaly Mycapssa<sup>®</sup> (oral octreatide) somatostatin analogs growth hormone IGF-1 |
| title | Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs |
| title_full | Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs |
| title_fullStr | Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs |
| title_full_unstemmed | Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs |
| title_short | Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs |
| title_sort | acromegaly pathophysiological considerations and treatment options including the evolving role of oral somatostatin analogs |
| topic | acromegaly Mycapssa<sup>®</sup> (oral octreatide) somatostatin analogs growth hormone IGF-1 |
| url | https://www.mdpi.com/1873-149X/30/3/29 |
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