“When health is absent, wisdom cannot reveal itself, art cannot become manifest, strength cannot be exerted, wealth is useless, and reason is powerless.” – Herophiles

PNA Spotlight: Dr. Nelson Oyesiku

This month the PNA Spotlight focuses on Dr. Nelson Oyesiku, systems neuroscience chief of Piedmont Healthcare in Atlanta, Georgia. He was formerly professor and chair of the Department of Neurological Surgery and professor of medicine (endocrinology) at the University of North Carolina, Chapel Hill. He earned his Bachelor of Medicine and Bachelor of Surgery at the University of Ibadan in Nigeria. He completed an MsC at the University of London and earned his PhD from Emory University, where he spent 35 years on staff.  Dr. Oyesiku was kind enough to answer questions from the PNA. His answers follow.

Please tell us the main focus of your practice

I’ve been primarily a pituitary surgeon for more than 30 years, so my main interest is in neuroendocrinology; including surgery and medical conditions of the pituitary gland.

Tell us about your professional journey

 I spent 35 years at Emory University. I left there in 2021 to take a position as chair of neurosurgery at University of North Carolina in Chapel Hill.  Then in April of this year, I joined Piedmont Healthcare Systems in Atlanta, Georgia, as a systems neuroscience chief.

What should people know about Piedmont’s approach?

I am now head of the neurosciences service line for all of Piedmont Healthcare, which includes oversight over neurosurgery, neurology, and psychiatry across all the Piedmont entities across the state of Georgia, which includes the hospitals, the clinics, and the practices of the providers in the neurosciences service line. That includes the pituitary and skull-based neuroendocrine lines as well. I’m also a practicing neurosurgeon.

What are your goals in this new position?

My goals are to develop, expand, and improve our neurosciences service line in terms of what we do in clinical delivery of care, quality, safety, and advancement of the field delivering patient-centered care.

What led you to choose this field?

When I first decided to go into medicine, I was influenced by a medical drama series that was on around that time called Ben Casey. It was a medical drama series whose protagonist was a resident in neurosurgery at San Francisco General. The series charted his course of training and was very popular at the time. It was one of the earliest medical drama series, long before Doogie Howser, Dr. Kildare, St. Elsewhere, or Grey’s Anatomy.

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PNA Medical Corner: Acromegaly treatment

This month the PNA Medical Corner features a study co-authored by PNA member Dr. Maria Fleseriu. The study finds that the combination of Pasireotide-LAR and pegvisomant are effective in treating mammosomatotroph adenomas.

Pituitary  2026 Sep 23;29(5):159.

doi: 10.1007/s11102-026-01750-1.

Pasireotide-LAR and pegvisomant combination in resistant acromegaly: a case series of predominantly mammosomatotroph adenomas

Edward Mignone ^1 2 3, Elena V Varlamov ^4 5 6, Rinki Pandya ⁶, Melanie Hakar ⁷, Maria Fleseriu ^4 5 6

• PMID: 42778805
• PMCID: PMC13601152
• DOI: 10.1007/s11102-026-01750-1

Abstract

Purpose: Long-term real-world data on concurrent pasireotide-LAR (PAS) and pegvisomant (PEGV) use in treatment-resistant acromegaly remain limited, especially for mammosomatotroph adenomas in younger adults. We report outcomes of six patients treated with this combination at a single tertiary pituitary center.

Methods: IRB-approved retrospective case series. Baseline and follow-up biochemical, radiological, histopathological, treatment and safety outcomes were captured.

Results: Six patients (5 females, 1 male; age 15 to 44 years) with somatotroph (n = 2) or mammosomatotroph (n = 4) adenomas, all macroadenomas, received PAS (20 to 60 mg every 28 days) plus PEGV (60 to 280 mg/week) over a median of 3.3 years (range 0.5 to 5.9) after lack of disease control post-surgery despite multiple lines of medical therapy. All six maintained tumor stability and achieved normal IGF-1. One had biochemical escape after 9 months of biochemical control requiring a 2nd surgery and radiosurgery. One patient discontinued PEGV after 3 years due to injection site pain, 3 patients developed hyperglycemia in the pre-diabetes range; no hepatotoxicity, acute symptomatic biliary disease, or arrhythmias occurred.

Conclusions: In this series of predominantly mammosomatotroph adenomas in younger adults, combination PAS plus PEGV offers potential durable biochemical control, tumor stability and PEGV dose reduction in treatment-resistant acromegaly. Glucose monitoring during treatment is essential as concomitant use of PEGV does not appear to mitigate PAS-induced glycemic deterioration. Larger prospective studies are needed to better define predictors of response.

Keywords: Acromegaly; Mammosommatotroph adenomas; Pasireotide; Pegvisomant; Treatment-resistant.

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