{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T06:03:28Z","timestamp":1776405808319,"version":"3.51.2"},"reference-count":82,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acromegaly is a rare disorder caused by a growth hormone-secreting pituitary adenoma. Clinical trial evidence for its management is limited. This study compared medical treatments for acromegaly through a network meta-analysis, assessing biochemical and radiological responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A systematic review and network meta-analysis were conducted following the preferred reporting items for systematic reviews and network meta-analyses guidelines and Cochrane Handbook recommendations (PROSPERO registration: CRD42023364373).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Scopus, and Web of Science were searched up to June 2024. Included studies were randomized controlled trials and nonrandomized studies evaluating the efficacy or safety of acromegaly treatments. Primary outcomes were the percentage of adjusted insulin-like growth factor 1 (IGF-1) normalization and tumor shrinkage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-seven studies, involving 4131 patients and 11 treatments were included. Pegvisomant was the best treatment for IGF-1 normalization, followed by pasireotide LAR. Both outperformed first-generation somatostatin receptor ligands (SRLs) combined with dopamine agonists (odds ratio [OR], 1.83; 95% CIs, 1.37-2.46 and OR, 1.46; 95% CIs, 1.02-2.08, respectively; I2 = 41%). Octreotide LAR was superior to oral octreotide capsules (OR, 5.41; 95% CIs, 1.89-15.52). For tumor shrinkage, pasireotide LAR was more effective than SRLs (n = 1059; OR, 11.47; 95% CIs, 1.5-87.64; I2 = 0%). Methodological heterogeneity may have affected comparability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf221","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T12:00:45Z","timestamp":1761307245000},"page":"S83-S94","source":"Crossref","is-referenced-by-count":2,"title":["Medical treatment in acromegaly: a network meta-analysis"],"prefix":"10.1093","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0400-4063","authenticated-orcid":false,"given":"Chrysi","family":"Kaparounaki","sequence":"first","affiliation":[{"name":"Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki 54124 ,","place":["Greece"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7248-7258","authenticated-orcid":false,"given":"Mirela-Diana","family":"Ilie","sequence":"additional","affiliation":[{"name":"Inserm U1052, CNRS UMR5286, Cancer Research Center of Lyon , Lyon 69373 ,","place":["France"]},{"name":"Endocrinology Department, \u201cC.I. Parhon\u201d National Institute of Endocrinology , Bucharest 011863 ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-1761","authenticated-orcid":false,"given":"Dario","family":"De Alcubierre","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, La Sapienza University of Rome , Rome 00185 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Anagnostis","sequence":"additional","affiliation":[{"name":"Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki 56403 ,","place":["Greece"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna-Bettina","family":"Haidich","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki , Thessaloniki 54124 ,","place":["Greece"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-5417","authenticated-orcid":false,"given":"Andrea M","family":"Isidori","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, La Sapienza University of Rome , Rome 00185 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-7580","authenticated-orcid":false,"given":"Olaf M","family":"Dekkers","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leiden University Medical Center , Leiden 2333 ZG ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5005-1995","authenticated-orcid":false,"given":"Dimitrios G","family":"Goulis","sequence":"additional","affiliation":[{"name":"Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki 56403 ,","place":["Greece"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9517-338X","authenticated-orcid":false,"given":"G\u00e9rald","family":"Raverot","sequence":"additional","affiliation":[{"name":"Inserm U1052, CNRS UMR5286, Cancer Research Center of Lyon , Lyon 69373 ,","place":["France"]},{"name":"Endocrinology Department, Reference Centre for Rare Pituitary Diseases HYPO , 59 Pinel Boulevard Bron 69677 ,","place":["France"]},{"name":"Faculty of Medicine, Lyon 1 University , Villeurbanne F-69100 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