Summary: In ACROINNOVA 1, adults with controlled acromegaly randomized from standard somatostatin-receptor ligand therapy to monthly CAM2029 maintained biochemical control more often than those switched to placebo withdrawal, 72.2% versus 37.5% for IGF-1 at week 22/24 (risk difference 34.6 percentage points, 95% CI 11.3 to 57.9; P=0.0018).
PICO Summary
| Element | Detail |
|---|---|
| Population | 72 adults with controlled acromegaly at 45 sites in 10 countries; randomized, double-blind, placebo-controlled phase 3 maintenance trial. |
| Intervention | Once-monthly CAM2029 subcutaneous octreotide depot after prior biochemical control on standard long-acting somatostatin-receptor ligand therapy (n=48). |
| Comparison | Placebo withdrawal from prior standard long-acting somatostatin-receptor ligand therapy (n=24). |
| Outcome | IGF-1 at or below the upper limit of normal at week 22/24 occurred in 72.2% versus 37.5%; risk difference 34.6 percentage points (95% CI 11.3 to 57.9; P=0.0018). Combined IGF-1 and GH control was 70.0% versus 37.5% (P=0.0035). |
CAM2029 in Acromegaly (ACROINNOVA 1)
Phase 3 RCT - controlled acromegaly - 24 weeks
Monthly self-injected CAM2029 maintained biochemical control better than placebo withdrawal in adults already controlled on somatostatin analog therapy.
Expert Commentary
ACROINNOVA 1 is clinically useful because it asks a practical maintenance question: can patients with controlled acromegaly stay biochemically controlled on a self-administered monthly octreotide depot rather than clinic-based long-acting injections? The answer is encouraging. At week 22/24, 72.2% of patients assigned to CAM2029 maintained IGF-1 at or below the upper limit of normal versus 37.5% on placebo withdrawal, an absolute advantage of 34.6 percentage points. Combined IGF-1 and GH control also favored CAM2029, and patient-reported symptom control, quality of life, and treatment satisfaction improved from baseline.
The main limitation is generalizability. Participants entered the trial already controlled on standard somatostatin-receptor ligand therapy, so this does not show how CAM2029 performs in newly diagnosed, treatment-naive, or biochemically uncontrolled acromegaly. The comparator was placebo withdrawal, not active head-to-head continuation with octreotide LAR or lanreotide, and only 72 patients were randomized. Longer follow-up and real-world adherence data still matter.
Can I use this with my patients?
Yes, for a patient already well controlled on injectable somatostatin analog therapy who wants a more convenient maintenance option and can reliably self-administer and attend IGF-1 and GH monitoring. This supports maintenance simplification, not rescue escalation therapy.
References
Tabarin A, Espiard S, Deutschbein T, et al. Octreotide Subcutaneous Depot for Acromegaly: A Randomized, Double-blind, Placebo-controlled Phase 3 Trial, ACROINNOVA 1. J Clin Endocrinol Metab. 2025;110(6):1729-1739. doi:10.1210/clinem/dgae707. PMID: 39378125.