Persistent remission of acromegaly in a patient with GH-secreting pituitary adenoma: Effect of treatment with pasireotide long-acting release and consequence of treatment withdrawal

What is known and objective Somatostatin analogues (SSAs) have been used for the treatment of acromegaly for several decades. However, a unified conclusion on the duration of SSAs therapy or the possibility of medication withdrawal is still missing. We aimed to report a case of acromegaly cured by pasireotide long-acting release (PAS-LAR) and provide some information on the withdrawal of SSAs after stable regression in acromegalic patients. Case summary A 55-year-old male patient, who was diagnosed with acromegaly and refused surgery and received PAS-LAR as initial treatment, had maintained stability for ten years under the regular treatment with PAS-LAR. The pituitary microadenoma was also decreased during the treatment. After the PAS-LAR discontinuation for 21 months, no evidence of biochemical or clinical recurrence was found in this patient. What is new and conclusion The use of PAS-LAR in a subset of naive-treatment patients is promising to induce long-term regression. A subgroup of patients with mild and well-controlled acromegaly might hope for perpetual remission after the withdrawal of medication.