Current perspectives on the impact of clinical disease and biochemical control on comorbidities and quality of life in acromegaly

Gatto, Federico; Campana, Claudia; Cocchiara, Francesco; Corica, Giuliana; Albertelli, Manuela; Boschetti, Mara; Zona, Gianluigi; Rossi, Diego Criminelli; Giusti, Massimo; Ferone, Diego

doi:10.1007/s11154-019-09506-y

Cited by 23 publications

(17 citation statements)

References 144 publications

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“…In the literature, the relationship between disease activity and the QoL of patients with acromegaly is controversial. Some studies have reported an improvement in QoL by biochemical remission, whereas researchers of several other studies have not observed any effect of disease activity on QoL (6,8,(21)(22)(23)(24)(25). In this study, only one patient (Patient-2) had an active disease; however, her results of BDI and Acro-QoL at baseline and follow-up were comparable with those of the other participants, and we could not observe an association between the disease activity and QoL.…”

Section: Discussioncontrasting

confidence: 79%

The Effects of Psychological Focus Group Therapy on the Quality of Life of Female Patients with Acromegaly

Haliloğlu¹,

Sözer²,

Korkmaz³

et al. 2020

Turk J Endocrinol Metab

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Section: Discussioncontrasting

confidence: 79%

The Effects of Psychological Focus Group Therapy on the Quality of Life of Female Patients with Acromegaly

Haliloğlu¹,

Sözer²,

Korkmaz³

et al. 2020

Turk J Endocrinol Metab

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“…Disease control represents the main goal in acromegalic patients, as it is strongly correlated with a better outcome in terms of both overall survival and prevention of comorbidities [19,20]. Discrepancy between GH and IGF-1, the two biochemical parameters used in the follow-up of acromegaly, is not a rare event, as it occurs in up to 25% of patients.…”

Section: Discussionmentioning

confidence: 99%

Discordant biological parameters of remission in acromegaly do not increase the risk of hypertension or diabetes: a study with the Liege Acromegaly Survey database

et al. 2020

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Purpose Acromegaly is a rare disease due to growth hormone (GH)-secreting pituitary adenoma. GH and IGF-1 levels are usually congruent, indicating either remission or active disease; however, a discrepancy between GH and IGF-1 may occur. We aimed to evaluate the outcome of diabetes mellitus (DM) and hypertension (HT) in acromegalic patients with congruent GH and/or IGF-1 levels vs. discordant biochemical parameters. Methods Retrospective analysis of the data of 3173 patients from the Liege Acromegaly Survey (LAS) allowed us to include 190 patients from 8 tertiary referral centers across Europe, treated by surgery, with available data concerning DM and HT both at diagnosis and at the last follow-up (LFU). We recorded the number of anti-HT and anti-DM drugs used at the first evaluation and at LFU for every patient. Results Ninety-nine patients belonged to the REM group (concordant parameters), 65 patients were considered as GH dis (high random GH/controlled IGF-1), and 26 patients were considered as IGF-1 dis (high IGF-1/controlled random GH). At diagnosis, 72 patients (37.8%) had HT and 54 patients had DM (28.4%). There was no statistically significant difference in terms of the number of anti-HT and anti-DM drugs at diagnosis versus LFU (mean duration: 7.3 ± 4.5 years) between all three groups. Conclusion The long-term outcome of DM and HT in acromegaly does not tend to be more severe in patients with biochemical discordance in comparison with patients considered as in remission on the basis of concordant biological parameters, suggesting that patients with biochemical discordance do not require a closer follow-up.

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“…40,41 The lower efficacy of first-generation SRLs observed over time could be explained by the preselection of patients (eg based on the responsiveness to short-term SRL-therapy), thus leading to a possible overestimation of the efficacy of long-term SRL treatment in acromegaly. 42…”

Section: First-line Medical Treatment and Biochemical Controlmentioning

confidence: 99%

<p>Octreotide-Resistant Acromegaly: Challenges and Solutions</p>

Corica¹,

Ceraudo²,

Campana³

et al. 2020

TCRM

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Acromegaly is a rare and severe disease caused by an increased and autonomous secretion of growth hormone (GH), thus resulting in high circulating levels of insulin-like growth factor 1 (IGF-1). Comorbidities and mortality rate are closely related to the disease duration. However, in most cases achieving biochemical control means reducing or even normalizing mortality and restoring normal life expectancy. Current treatment for acromegaly includes neurosurgery, radiotherapy and medical therapy. Transsphenoidal surgery often represents the recommended first-line treatment. First-generation somatostatin receptor ligands (SRLs) are the drug of choice in patients with persistent disease after surgery and are suggested as first-line treatment for those ineligible for surgery. However, only about half of patients treated with octreotide (or lanreotide) achieve biochemical control. Other available drugs approved for clinical use are the second-generation SRL pasireotide, the dopamine agonist cabergoline, and the GH-receptor antagonist pegvisomant. In the present paper, we revised the current literature about the management of acromegaly, aiming to highlight the most relevant and recent therapeutic strategies proposed for patients resistant to first-line medical therapy. Furthermore, we discussed the potential molecular mechanisms involved in the variable response to first-generation SRLs. Due to the availability of different medical therapies, the choice for the most appropriate drug can be currently based also on the peculiar clinical characteristics of each patient.

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Current perspectives on the impact of clinical disease and biochemical control on comorbidities and quality of life in acromegaly

Cited by 23 publications

References 144 publications

The Effects of Psychological Focus Group Therapy on the Quality of Life of Female Patients with Acromegaly

The Effects of Psychological Focus Group Therapy on the Quality of Life of Female Patients with Acromegaly

Discordant biological parameters of remission in acromegaly do not increase the risk of hypertension or diabetes: a study with the Liege Acromegaly Survey database

<p>Octreotide-Resistant Acromegaly: Challenges and Solutions</p>

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