Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: A meta-analysis of published observational studies

Jennifer C Stone, Justin Clark, Ross Cuneo, Anthony W Russell, Suhail A R Doi

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Abstract

Estrogen and selective estrogen receptor modulator (SERM) treatments for acromegaly have received limited attention since the development of newer pharmacologic therapies. There has been ongoing research evidence suggesting their utility in the biochemical control of acromegaly. Therefore, the aim of this meta-analysis was to synthesise current evidence with a view to determining to what extent and in which acromegalic patient subsets do estrogen and SERMs reduce IGF-1 levels. A literature search was conducted (finished December 2012), which included all studies pertaining to estrogen or SERM treatment and IGF-1. Seven patient subsets were identified from six published observational studies, and were pooled using meta-analytic methods. Overall, the pooled mean loss in IGF-1 was -29.09 nmol/L (95 % CI -37.23 to -20.95). A sensitivity analysis indicated that women receiving estrogen had a substantially greater reduction in IGF-1 levels compared with women receiving SERMs, with a weighted mean loss in IGF-1 of -38.12 nmol/L (95 % CI -46.78 to -29.45) compared with -22.91 nmol/L (95 % CI -32.73 to -13.09). There was a trend that did not reach statistical significance for men receiving SERM treatment at -11.41 nmol/L (95 % CI -30.14 to 7.31). It was concluded that estrogen and SERMs are a low cost and effective treatment to achieve control of IGF-1 levels in acromegalic women either as concomitant treatment for refractory disease, or where access to conventional therapy is restricted. Their use in men requires further study.

Original languageEnglish
Pages (from-to)284-95
Number of pages12
JournalPituitary
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 2014
Externally publishedYes

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Selective Estrogen Receptor Modulators
Acromegaly
Insulin-Like Growth Factor I
Observational Studies
Meta-Analysis
Estrogens
Therapeutics
Health Care Costs
Research

Cite this

Stone, Jennifer C ; Clark, Justin ; Cuneo, Ross ; Russell, Anthony W ; Doi, Suhail A R. / Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly : A meta-analysis of published observational studies. In: Pituitary. 2014 ; Vol. 17, No. 3. pp. 284-95.
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Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly : A meta-analysis of published observational studies. / Stone, Jennifer C; Clark, Justin; Cuneo, Ross; Russell, Anthony W; Doi, Suhail A R.

In: Pituitary, Vol. 17, No. 3, 06.2014, p. 284-95.

Research output: Contribution to journalArticleResearchpeer-review

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