somatostatineanalogen

Somatostatineanalogen are drugs that mimic the natural hormone somatostatin, which inhibits the secretion of several hormones and slows gastrointestinal activity. These agents act as agonists at somatostatin receptors (SSTR1-5) and produce effects such as suppression of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), as well as reduced release of multiple digestive hormones. By dampening hormone hypersecretion from neuroendocrine tumors and lowering GH/IGF-1 in acromegaly, they help control symptoms and, in some cases, tumor growth.

The main clinical analogs are octreotide, lanreotide and pasireotide. Octreotide and lanreotide have high affinity for SSTR2 and are effective in controlling GH/IGF-1 excess and tumor-related symptoms in acromegaly and neuroendocrine tumors. Pasireotide has broader receptor affinity, including SSTR5, and is used in certain tumors and Cushing’s disease when first-generation analogs are less effective.

Formulations and administration vary: octreotide is available as subcutaneous injections and in a long-acting release (LAR) depot given monthly. Lanreotide is provided as an autogel depot injected every 4 weeks. Pasireotide is available as a long-acting release injection given monthly. In addition to endocrinology uses, octreotide is employed to manage acute variceal bleeding and other bleeding from portal hypertension, reflecting its inhibitory effects on splanchnic circulation and hormone secretion.

Common adverse effects include gastrointestinal symptoms (nausea, diarrhea, abdominal discomfort), gallstone formation due to reduced gallbladder motility, steatorrhea, and changes in glucose metabolism (hyperglycemia or hypoglycemia). Monitoring of glucose, gallbladder status, and hormone levels is recommended during therapy.