SynthesisPituitary2015
Preoperative somatostatin analogues versus direct transsphenoidal surgery for newly-diagnosed acromegaly patients: a systematic review and meta-analysis using the GRADE system.
Synthesis in Pituitary, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Surgical and non-surgical interventions for primary and salvage treatment of growth hormone-secreting pituitary adenomas in adults.The Cochrane database of systematic reviews · 2024Pooled it
- Preoperative Somatostatin Analogues in Patients with Newly-diagnosed Acromegaly: A Systematic Review and Meta-analysis of Comparative Studies.Scientific reports · 2019Pooled it
- Review
- Consensus on acromegaly therapeutic outcomes: an update.Nature reviews. Endocrinology · 2025Review
- Preoperative medical therapy for acromegaly: current knowledge and clinical significance.Frontiers in endocrinology · 2025Review
- Biochemical Control in a Colombian Cohort of Patients With Acromegaly: A 12-Month Follow-Up Study (2017-2023).Cureus · 2024Article
- Long-term control of acromegaly after pituitary surgery in South-Eastern Norway.Acta neurochirurgica · 2023Article
- A retrospective study of the role of hypercapnia in patients with acromegaly.BMC pulmonary medicine · 2023Article
- Article
- Preoperative medical treatments and surgical approaches for acromegaly: A systematic review.Clinical endocrinology · 2023Review
- Preoperative Medical Treatment for Patients With Acromegaly: Yes or No?Journal of the Endocrine Society · 2022Review
- Predictors for Remission after Transsphenoidal Surgery in Acromegaly: A Dutch Multicenter Study.The Journal of clinical endocrinology and metabolism · 2021Article
- Multidisciplinary management of acromegaly: A consensus.Reviews in endocrine & metabolic disorders · 2020Review
- Development and assessment of machine learning algorithms for predicting remission after transsphenoidal surgery among patients with acromegaly.Endocrine · 2020Article
- Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 2: Therapeutic Issues.Endocrine, metabolic & immune disorders drug targets · 2020Review
- The effects of pre-operative somatostatin analogue therapy on treatment cost and remission in acromegaly.Pituitary · 2019Article
- Effects of somatostatin analog treatment on cardiovascular parameters in patients with acromegaly: A systematic review.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2019Review
- International Union of Basic and Clinical Pharmacology. CV. Somatostatin Receptors: Structure, Function, Ligands, and New Nomenclature.Pharmacological reviews · 2018Review
- A Consensus Statement on acromegaly therapeutic outcomes.Nature reviews. Endocrinology · 2018Review
- Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1-3): a retrospective cohort study conducted at a single center.BMC endocrine disorders · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledWhether the preoperative use of somatostatin analogues (SA) improves surgical outcomes in acromegaly is still a matter of debate.
objectiveWe conducted a systematic review of randomized, controlled trials that compared the short-term outcomes of preoperative use of SA (Pre-SA) with direct TSS (No-SA) for the treatment of newly diagnosed acromegaly.
methodsEmbase, Pubmed, Lilacs, and Central Cochrane were used as our data sources. The primary outcomes were no need for any adjuvant treatment 3 months after surgery, based on biochemical results (GH nadir after OGTT <1 μg/L and normal IGF-1 for age and gender), quality of life and mortality. The included trials were analyzed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
resultsA total of 2.099 references were identified and two reviewers independently screened the titles and abstracts. From the 14 potentially eligible studies, four were included and ten were excluded due to lack of randomization or different outcomes. A pool of 261 patients was randomly assigned to Pre-SA or No-SA. Meta-analysis of IGF1 normalization showed a significant difference in favor of Pre-SA (RR 2.47; 95% CI 1.66, 3.77). Adding a GH nadir on OGTT ≤1 μg/L, we found a RR of 2.15 (95% CI 1.39, 3.33). Quality of evidence for no need of adjuvant postoperative treatment was moderate, but for improving quality of life was very low and for mortality was absent.
conclusionPre-SA increases the chance of biochemical control of acromegaly 3 months after TSS in patients harboring GH-secreting pituitary macroadenomas.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.