Epidemiology of acromegaly in Italy: analysis from a large longitudinal primary care database

Gatto, Federico; Trifirò, Gianluca; Lapi, Francesco; Cocchiara, Francesco; Campana, Claudia; Dell’Aquila, Carlotta; Ferrajolo, Carmen; Arvigo, Marica; Cricelli, Claudio; Giusti, Massimo; Ferone, Diego

doi:10.1007/s12020-018-1630-4

Cited by 29 publications

(26 citation statements)

References 44 publications

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“…The prevalence and incidence of acromegaly in Japan in the present study were comparable to those reported in other countries by previous studies [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. A nationwide hospital survey in South Korea, a country adjacent to Japan, provided with the corresponding rates of 2.8 cases per 100,000 and 0.4 cases per 100,000 [14].…”

Section: Discussionsupporting

confidence: 88%

“…Previous studies on the epidemiology of acromegaly have reported the prevalence of 1.8-13.7 per 100,000 people, the annual incidence of 0.2-1.2 per 100,000 people, and the ratio of males to females is roughly 1:1 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. In Japan, a questionnaire survey of large hospitals nationwide in 1993 reported 815 cases with acromegaly within the past five years [24], but few recent epidemiological data on acromegaly have been reported.…”

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confidence: 99%

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Prevalence, incidence, comorbidities, and treatment patterns among Japanese patients with acromegaly: a descriptive study using a nationwide claims database

Matsubayashi

Kawakami

2020

Endocr J

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Epidemiological data of rare diseases are important for understanding disease burden, improving treatment, and planning healthcare systems. However, those of acromegaly in Japan are not well known. Our study aimed to describe the prevalence, incidence, prediagnostic comorbidities, and treatment patterns of patients with acromegaly in Japan. Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan, we retrospectively identified 12,713 patients with acromegaly aged ≥20 years between January 2014 and December 2017 (the prevalence cohort), 2,552 newly diagnosed patients between January 2013 and December 2017 (the incidence and comorbidity cohort), and 2,125 patients enrolled in the database at least 365 days after the diagnosis (the treatment-pattern cohort). The average annual prevalence in 2015-2017 was 9.2 cases per 100,000 in the prevalence cohort, and the average annual incidence in 2013-2017 was 0.49 cases per 100,000 in the incidence and comorbidity cohort. The most common prediagnostic comorbidities included hypertension (43%), diabetes (37%), and hyperlipidemia (27%). In the treatment-pattern cohort, 54% and 45% of patients received surgery and medical treatment as the primary treatment, respectively. Between the first surgery and 365 days after diagnosis, 15% of the patients in this cohort received medical treatment as the secondary treatment, mostly with somatostatin analogs (83%). Of the 1,569 patients who underwent surgery, 29% received medical treatment before surgery. The prevalence and incidence of acromegaly in Japan were similar to those in other countries. This epidemiological study provides the basis for better management of acromegaly nationwide.

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Section: Discussionsupporting

confidence: 88%

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confidence: 99%

Prevalence, incidence, comorbidities, and treatment patterns among Japanese patients with acromegaly: a descriptive study using a nationwide claims database

Matsubayashi

Kawakami

2020

Endocr J

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“…Two thirds were diagnosed before 65 years of age, therefore we cannot exclude an in uence of disease duration on our results. Indeed, it is well consolidated that disease duration in uences comorbidities development and worsening [32]. ACRO group was predominantly represented by females, in agreement with recent Italian series [20,21,33].…”

Section: Discussionsupporting

confidence: 82%

Multidimensional Geriatric Evaluation in Acromegaly: A Comparative Cross-Sectional Study

Gagliardi

Chiloiro

Vallillo

et al. 2021

Preprint

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Background: Improvement in acromegaly management increased disease survival and prevalence. Evidence regarding acromegaly in older adults are sparse. We aim to explore acromegaly impact on aging process quality.Methods: Multicenter case-control study conducted on 42 older adults (≥ 65 years) acromegaly patients (ACRO) compared to an age- and gender-matched control group (CTR). Each participant underwent a multidimensional geriatric evaluation.Results: Mean age in both groups was 73 ± 6 years and female gender was most represented (69%). 13 ACRO were in remission and 29 had active disease controlled by medical therapy except for one patient. ACRO showed worse physical performance and mobility skills worsening with age as compared to CTR. ACRO performed poorly in functional status assessment, and age negatively correlated with instrumental and basic daily activities execution. Cognitive evaluation was significantly impaired in ACRO vs. CTR, worsening with age. No difference was found concerning nutritional and psychological status. Musculoskeletal and bone diseases were more frequent in ACRO than in CTR (52% vs. 12%; 64% vs. 10%; P< 0.05) and independently associated with geriatric outcomes in ACRO. ACRO reported a less satisfactory quality of life concerning physical activity and pain, general health, vitality, social activities.Conclusions: Our study demonstrates increased frailty of older acromegaly patients as compared to non-acromegaly patients with a consequent negative impact on their quality of life. Therefore, it seems advisable to include physical, functional, cognitive, nutritional, and psychological status assessments in routine clinical practice. Further studies are needed to identify the most appropriate geriatric tools.

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“…1,2 The incidence is approximately 3 cases per 1 million persons per year, though more recent estimates report an increased incidence (about 11 per million person-years). [3][4][5][6] As far as prevalence, some studies estimate that the disease affects 40-70 patients per million of the general population, or even more (86-240 per million). 7,8 Comorbidities and mortality risk in acromegalic patients are related to time of exposure to GH and IGF-1 excess.…”

Section: Introductionmentioning

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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Epidemiology of acromegaly in Italy: analysis from a large longitudinal primary care database

Cited by 29 publications

References 44 publications

Prevalence, incidence, comorbidities, and treatment patterns among Japanese patients with acromegaly: a descriptive study using a nationwide claims database

Prevalence, incidence, comorbidities, and treatment patterns among Japanese patients with acromegaly: a descriptive study using a nationwide claims database

Multidimensional Geriatric Evaluation in Acromegaly: A Comparative Cross-Sectional Study

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

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