Fibrous Dysplasia of Bone with Growth Hormone Excess (FD/MAS): Treatment After Somatostatin Analogue Failure
In fibrous dysplasia of bone associated with FD/MAS, growth hormone excess requires active hormonal management. When first-line therapy does not bring IGF-1 into the target range, a defined second-line approach is indicated.
Clinical Scenario
Growth hormone excess associated with FD/MAS, where adequate IGF-1 control has not been achieved on first-line therapy.
First-Line Failure Condition
Prior therapy: Somatostatin analogues — octreotide or lanreotide — as first-line treatment.
Target not reached: IGF-1 Z-score between −2 and +1.
This protocol applies when somatostatin analogue therapy has failed to normalise IGF-1 and escalation is required.
Second-Line Treatment Approach
Second-line management in this setting involves a pegvisomant-based therapy, with the specific regimen, combination options, and individualised decisions contained in the full protocol.
Complete guidance on regimen selection is available via the link below.
Treatment Goal
Target: IGF-1 Z-score between −2 and +1.
References
DOI: 10.1186/s13023-019-1102-9
- Somatostatin analogues are first line therapies with second line options including pegvisomant, alone or in combination with octreotide or lanreotide at the discretion of the treating physician.
- The treatment goals are to achieve an IGF-1 Z-score between −2 and +1.
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