{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:03:54Z","timestamp":1783994634475,"version":"3.55.0"},"reference-count":26,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background\/Objectives: Acromegaly is a chronic endocrine disorder caused mainly by GH-secreting pituitary adenomas, leading to excess GH and elevated IGF-1. Although surgery is first-line therapy, many patients require medical treatment, and remission is often not achieved with first-generation somatostatin receptor ligands (SRLs). Pasireotide, a second-generation SRL, offers superior biochemical and tumor control but is associated with hyperglycemia. This study aimed to evaluate real-world outcomes associated with pasireotide treatment in patients with acromegaly inadequately controlled on first-generation SRLs, with IGF-1 normalization as the primary endpoint. Secondary outcomes included GH control, tumor response, and glycemic safety. Methods: We conducted a historical cohort study of adults with acromegaly treated at Cl\u00ednica Imbanaco (Cali, Colombia) between 2017 and 2024. Eligible patients had residual tumors and persistently elevated GH and\/or IGF-1 levels above the age-adjusted upper limit of normal despite treatment with clinically adequate doses of first-generation SRLs, as well as 12 months of continuous pasireotide treatment and follow-up after pasireotide initiation. Demographic, biochemical, imaging, and glycemic data were collected. Statistical analysis included paired and independent Student\u2019s t-tests, Wilcoxon signed-rank tests, McNemar\u2019s test, and Fisher\u2019s exact test, with significance set at p &lt; 0.05. Results: Fourteen patients (50% female; mean age 52.1 \u00b1 14.5 years) were included. After 12 months, mean IGF-1 decreased from 2.73 \u00b1 0.73 to 0.99 \u00b1 0.56 \u00d7 ULN, and 50% achieved IGF-1 normalization. Additionally, 35.7% achieved GH &lt; 1 ng\/mL, and 14.3% achieved combined control. Mean tumor diameter decreased by \u22123.26 mm (95% CI \u22124.56 to \u22121.95; p &lt; 0.001). HbA1c increased from 5.56% to 6.05%, while type 2 diabetes mellitus prevalence rose from 14.3% to 35.7%. No patient discontinued pasireotide due to metabolic adverse events. Conclusions: Pasireotide was associated with favorable biochemical and tumor responses in patients with acromegaly inadequately controlled on first-generation SRLs under real-world conditions. Although treatment was associated with higher HbA1c and increased diabetes incidence, proactive monitoring and early management of hyperglycemia may have supported treatment persistence.<\/jats:p>","DOI":"10.3390\/life16071114","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T15:15:04Z","timestamp":1783091704000},"page":"1114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current Insights into Pasireotide Therapy for Uncontrolled Acromegaly: Biochemical Response, Tumor Reduction, and Glycemic Safety in a Real-World Latin American Cohort"],"prefix":"10.3390","volume":"16","author":[{"given":"Alin","family":"Abreu Lomba","sequence":"first","affiliation":[{"name":"Grupo Interinstitucional de Medicina Interna (GIMI1), Universidad Libre, Cali 760045, Colombia"},{"name":"Endocrinology Department, Cl\u00ednica Imbanaco, Cali 760042, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7067-1584","authenticated-orcid":false,"given":"David Alexander","family":"Vernaza Trujillo","sequence":"additional","affiliation":[{"name":"Grupo Interinstitucional de Medicina Interna (GIMI1), Universidad Libre, Cali 760045, Colombia"},{"name":"Department of Public Health, Pontificia Universidad Javeriana, Cali 760031, Colombia"},{"name":"Clinical Research Center, Cl\u00ednica Imbanaco, Cali 760042, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Andr\u00e9s","family":"Tafur Monje","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Cl\u00ednica Nueva de Cali, Cali 760044, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6079-6974","authenticated-orcid":false,"given":"Wilfredo Antonio","family":"Rivera-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Endocrinology Department, IPS Nauru, Cali 760042, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar Augusto","family":"Mej\u00eda V\u00e9lez","sequence":"additional","affiliation":[{"name":"Grupo Interinstitucional de Medicina Interna (GIMI1), Universidad Libre, Cali 760045, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-0546","authenticated-orcid":false,"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas, Quito 170513, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","first-page":"e780","article-title":"Consenso sobre definici\u00f3n de criterios diagn\u00f3sticos, terap\u00e9uticos y de seguimiento de la acromegalia en pacientes colombianos","volume":"9","author":"Giraldo","year":"2022","journal-title":"Rev. Colomb. Endocrinol. Diabetes Metab."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gadelha, M., Bex, M., Colao, A., Garc\u00eda, E.M.P., Poiana, C., Jimenez-Sanchez, M., Yener, S., Mukherjee, R., Bartalotta, A., and Maamari, R. (2020). Evaluation of the efficacy and safety of switching to pasireotide in patients with acromegaly inadequately controlled with first-generation somatostatin analogs. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00931"},{"key":"ref_3","first-page":"e904","article-title":"Clinical and treatment response differences according to age and gender in patients with acromegaly in Colombia: A retrospective study","volume":"12","author":"Lomba","year":"2025","journal-title":"Rev. Colomb. Endocrinol. 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