Table 1.

Studies on the effects of first-generation SSAs in acromegaly patients.

First author and year of publication	Study design	Results
Giordano et al. (22)	Retrospective, comparative study 12 months follow-up of 231 patients: 151 treated with first-generation SSAs and 80 with surgery as first line therapy	Significant reduction of FPG, HbA1c and DM prevalence in controlled patients in both group Significant reduction in insulinogenic index only in controlled SSAs-treated patients.
Sagvand et al. (59)	Retrospective, comparative, longitudinal case-control study 24 acromegaly patients receiving lanreotide autogel treatment for at least 24 months compared with 39 surgically-cured patients	Mean HbA1c levels similar in both groups. Increased prevalence of DM only in the lanreotide group.
Colao et al. (57)	Open-Prospective study 12 months follow-up of 112 patients receiving primary lanreotide treatment	Glucose homeostasis correlates with the achievement of disease control.
Couture et al. (58)	Retrospective study 42 patients receiving primary lanreotide autogel treatment for a mean period of 23 months.
Valea et al. (53)	Retrospective observational study 12-36 months follow-up of 22 patients treated with lanreotide
Caron et al. (51)	Retrospective study 12 months follow-up of 25 patients treated with octreotide LAR.	Overall minor clinical impact on glucose mebabolism.
Salvatori et al. (63)	Open-label, multicenter observational study. 24 months follow-up of 241 patients treated with lanreotide autogel.
Mazziotti et al. (54)	Meta-analysis of 31 studies, performed from 1987 to 2008, on acromegaly patients treated with first-generation SSAs for at least 3 weeks	Only modest impairment of glucose response to OGTT
Cozzolino et al. (56)	Meta-analysis of 47 prospective interventional trials treating 1,297 acromegaly patients with first-generation SSAs for at least 6 months	Reduction of insulin levels, increase of after load glucose and of HbA1c levels, without affecting FPG
Mazziotti et al.(61)	Post-hoc analysis on 26 patients non-responders to conventional doses of first-generation SSAs and randomized to receive high doses or high frequency octreotide LAR for 6 months	No significant impairment of glucose metabolism with high doses or high frequency lanreotide therapy
Caron et al.(55)	Prospective multicenter open-label single-arm study (PRIMARYS study) 48-week follow-up of 64 patients receiving high doses lanreotide autogel treatment
Caron et al.(62)	Extension of the PRIMARYS study Post-hoc metabolic profile analysis
Giustina et al. (60)	Prospective, multicenter, randomized, open-label trial 30 patients partially responders to conventional doses of SSAs randomized to receive high doses or high frequency lanreotide autogel for 24 weeks

SSAs, somatostatin analogs; FPG, fasting plasma glucose; DM, diabetes mellitus; HbA1c, glycosylated hemoglobin; OGTT, oral glucose tolerance test.