A Nationwide Survey of Mortality in Acromegaly

Kauppinen‐Mäkelin, Ritva; Sane, Timo; Reunanen, Antti; Välimäki, Matti; Niskanen, Leo; Markkanen, Helene; Löyttyniemi, Eliisa; Ebeling, Tapani; Jaatinen, Pia; Laine, Hanna; Nuutila, Pirjo; Salmela, Pasi; Salmi, Jorma; Stenman, Ulf‐Hǎkan; Viikari, Jorma; Voutilainen, Erkki

doi:10.1210/jc.2004-1381

Cited by 245 publications

(250 citation statements)

References 19 publications

Supporting

Mentioning

202

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, in the subgroup of irradiated patients, mortality was significantly increased (SMR 2.7), confirming data reported by Ayuk (SMR 1.58) and from Finland (SMR 1.69) (5). In contrast, the mortality observed in the non-irradiated patients in all three studies was not different from the general population (SMR of 0.92, 0.95 and 0.94 respectively).…”

Section: Discussionsupporting

confidence: 87%

“…Median age at death in the Belgian survey (68 years in men and 74 years in women) is higher than reported in previous series: 60 years in REA (12), 61 years in Quebec (8) and New Zealand (6), but close to the 64 years for men and 69 years for women in Finland (5) and the 66 years in the West Midlands database (4). By comparison, current life expectancy in Belgium is 75.6 in men and 81.7 years in women.…”

Section: Discussioncontrasting

confidence: 64%

“…In the larger Spanish database REA, using less strict criteria and multiple assays, cure was reported in 35% of 1084 evaluated patients (12). Finally, in the Finnish database, results derived from the GH data (55% of 314!2.5 mg/l) and IGF-I data (normal in 55% of 241) were not combined, but it is likely that the global control rate using both criteria was also below 50% (5).…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the study, control of GH (2)(3)(4)(5)(6) and/or normalisation of IGF-I (6-9) are associated with a reversal of the increased mortality and a near normalisation of life expectancy. The aims of therapy and criteria for cure have been previously defined in a consensus statement (10).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

AcroBel – the Belgian registry on acromegaly: a survey of the ‘real-life’ outcome in 418 acromegalic subjects

Bex¹,

et al. 2007

View full text Add to dashboard Cite

Objectives: To constitute a registry on acromegaly, AcroBel, to evaluate the epidemiology and quality of care of acromegaly in Belgium and Luxembourg. Design: A nationwide survey from June 2003 till September 2004 aiming to collect data from all patients with acromegaly who had visited the participating endocrine clinics after 1 January 2000. Methods: Retrospective data collection coupled to a visit within the survey period, allowing sampling of metabolic parameters and centralised determination of GH and IGF-I. Results: Four hundred and eighteen patients (51% men) were included, of which 96 were new cases, giving a mean incidence of 1.9 cases per million (c.p.m.) per year. The global prevalence was 41 c.p.m. but varied between 21 and 61 among different areas. Twenty-eight deaths were reported at a median age of 68 years in men and 74 years in women. The standardised mortality rate was significantly increased only in irradiated patients (2.70; confidence interval 1.60-4.55). Central measurements were available in 316 (75%) patients. Mean GH was %2 mg/l in 65% and IGF-I was normal for age in 56%, while both criteria were fulfilled in 49%. Multimodal treatment was more effective than primary medical therapy, since 56.5% were controlled versus 24.3% (P!0.0001). Conclusions: AcroBel provides an excellent tool to analyse the prevalence, incidence, treatment modalities and outcome of acromegaly in Belgium. This real-life survey reveals that only half of acromegalic patients received an adequate therapy resulting in cure or disease control when stringent biochemical criteria are used.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

AcroBel – the Belgian registry on acromegaly: a survey of the ‘real-life’ outcome in 418 acromegalic subjects

Bex¹,

et al. 2007

View full text Add to dashboard Cite

show abstract

“…In patients with more advanced disease, successful therapy eliminates or resolves all manifestations of the disease in a minority, and diminished qualityof-life persists in the majority (24). Overall morbidity and mortality, related primarily to chronic cardiovascular disease, is a function of biochemical control: risk of mortality may be as high as 3.5-fold greater in patients with persistent disease compared with those in remission (22,23,(25)(26)(27)(28). Although molecular diagnosis of PAP in unselected pituitary adenomas would be first performed in a research setting, thousands of paraffin-embedded somatotropinoma samples in the United States alone are available for prescreening of PAP by AIP IHC, pending consent from the patients.…”

Section: Discussionmentioning

confidence: 99%

Molecular diagnosis of pituitary adenoma predisposition caused by aryl hydrocarbon receptor-interacting protein gene mutations

Georgitsi

Raitila

Karhu

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

Self Cite

169

151

View full text Add to dashboard Cite

Pituitary adenomas are common neoplasms of the anterior pituitary gland. Germ-line mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene cause pituitary adenoma predisposition (PAP), a recent discovery based on genetic studies in Northern Finland. In this population, a founder mutation explained a significant proportion of all acromegaly cases. Typically, PAP patients were of a young age at diagnosis but did not display a strong family history of pituitary adenomas. To evaluate the role of AIP in pituitary adenoma susceptibility in other populations and to gain insight into patient selection for molecular screening of the condition, we investigated the possible contribution of AIP mutations in pituitary tumorigenesis in patients from Europe and the United States. A total of 460 patients were investigated by AIP sequencing: young acromegaly patients, unselected acromegaly patients, unselected pituitary adenoma patients, and endocrine neoplasia-predisposition patients who were negative for MEN1 mutations. Nine AIP mutations were identified. Because many of the patients displayed no family history of pituitary adenomas, detection of the condition appears challenging. Feasibility of AIP immunohistochemistry (IHC) as a prescreening tool was tested in 50 adenomas: 12 AIP mutation-positive versus 38 mutation-negative pituitary tumors. AIP IHC staining levels proved to be a useful predictor of AIP status, with 75% sensitivity and 95% specificity for germ-line mutations. AIP contributes to PAP in all studied populations. AIP IHC, followed by genetic counseling and possible AIP mutation analysis in IHC-negative cases, a procedure similar to the diagnostics of the Lynch syndrome, appears feasible in identification of PAP.immunohistochemistry ͉ growth hormone/prolacting-secreting adenomas ͉ acromegaly

show abstract

Somatostatin analogues, dopamine agonists or growth hormone antagonists for pituitary adenoma-induced acromegaly.

Balti

Akwo

Fezeu

et al. 2010

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

A Nationwide Survey of Mortality in Acromegaly

Abstract: The posttreatment basal GH concentration less than 2.5 microg/liter in acromegalic patients is associated with a normal lifespan. Excess mortality is confined to poorly controlled patients and possibly those who have received conventional radiotherapy.

Cited by 245 publications

References 19 publications

AcroBel – the Belgian registry on acromegaly: a survey of the ‘real-life’ outcome in 418 acromegalic subjects

AcroBel – the Belgian registry on acromegaly: a survey of the ‘real-life’ outcome in 418 acromegalic subjects

Molecular diagnosis of pituitary adenoma predisposition caused by aryl hydrocarbon receptor-interacting protein gene mutations

Somatostatin analogues, dopamine agonists or growth hormone antagonists for pituitary adenoma-induced acromegaly.

Contact Info

Product

Resources

About