Abstract
Guidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of Endocrine Society guidelines and Acromegaly Consensus Group statements. This update focuses on how recent key advances affect treatment decision-making and outcomes, and also highlights the likely role of recently FDA-approved therapies as well as novel combination therapies within the treatment armamentarium.
Highlights
Guidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes.Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of EndocrineSociety guidelines [1] and Acromegaly Consensus Group statements [2, 3].This update focuses on how recent key advances affect treatment decision-making and outcomes, and highlights the likely role of recently FDA-approved therapies as well as novel combination therapies within the treatment armamentarium
Men present at a younger age than do women, women may show both increased incidence and mortality risk. (MQ, Discretionary recommendation (DR)) Biochemical control remains the strongest predictor of patient outcomes, reflecting improvements in glucose metabolism, obstructive sleep apnea (OSA), cardiovascular disease, and vertebral fractures (VF)
Patients with a hypointense tumor on T2 MRI showed greater reductions in IGF-I and were more likely to achieve tumor shrinkage [60]. These results suggest that patient- and tumor-specific factors at baseline may predict long-term biochemical response to primary somatostatin receptor ligands (SRL) treatment, while early tumor response may not
Summary
Guidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. A metaanalysis [30] that included 24 studies (n = 734) showed significant AHI improvement after medical or surgical treatment (effect size − 0.36; 95% CI − 0.49, − 0.23; p < 0.001), and another study of 27 patients [31] showed that 69% of patients with OSA at baseline were cured after achieving acromegaly disease control. QOL improved but did not normalize in a prospective study of 27 patients followed for 2.5 years after diagnosis, all of whom achieved disease control with surgery and/or medical therapy, especially in the first year of treatment [32]. A patient-centric approach for QOL assessment may allow a more personalized method of management [34], and tools such as the recently developed Acromegaly Treatment Satisfaction Questionnaire (Acro-TSQ) show improved QOL with disease control [11], in patients treated with injectable SRL [35]. Comparing 178 patients and 356 controls, colorectal polyps were found in 67% of patients in the acromegaly group and in 24% of the control group (p < 0.001), but there was no difference in histology subtypes [44]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
