Bonert V, Mirocha J, Carmichael J, et al. - Researchers conducted this prospective, randomized trial to compare the cost-effectiveness and efficacy of three lower-dose combination regimens in controlled and uncontrolled acromegaly. Adults with acromegaly irrespective of prior somatostatin receptor ligand (SRL) response and baseline biochemical control status, stratified by the SRL dose needed for IGF-I normalization over any 3-month span within 12 months prior to enrolment. Sixty patients were registered and 52 patients were assessable. Fifty out of 52 (96%) exhibited IGF-I control regardless of prior SRL responsiveness. In patients with uncontrolled acromegaly requiring combination therapy, low-dose SRL plus weekly pegvisomant represents a novel dosing alternative to achieve cost-effective, optimal biochemical control.