Expert consensus document: A consensus on the medical treatment of acromegaly

Giustina, Andrea; Chanson, Philippe; Kleinberg, David L.; Bronstein, Marcello D.; Clemmons, David R.; Klibanski, Anne; Lely, Aart Jan van der; Strasburger, Christian J.; Lamberts, Steven W. J.; Ho, Ken K. Y.; Casanueva, Felipe F.; Melmed, Shlomo

doi:10.1038/nrendo.2014.21

Cited by 322 publications

(322 citation statements)

References 75 publications

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“…This contrasts with effective drugs available (10,11) for the treatment of hormonesecreting pituitary tumors.…”

Section: Introductionmentioning

confidence: 75%

“…Nevertheless, as these tumors are mostly invasive macroadenomas, a complete resection is challenging. Most patients harbor residual postoperative tumor tissue, which, if left untreated, is associated with progression rates of over 40% in [5][6][7][8][9][10] years (3,4,5). Radiation therapy may be effective in preventing residual tumor growth (6), but is associated with a high rate of complications, thus limiting routine use (7,8).…”

Section: Introductionmentioning

confidence: 99%

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Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists

Greenman

Cooper

Yaish

et al. 2016

European Journal of Endocrinology

109

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Objective: Clinically nonfunctioning pituitary adenoma (NFPA) remains the only pituitary tumor subtype for which no effective medical therapy is available or recommended. We evaluated dopamine agonist (DA) therapy for preventing growth of postsurgical pituitary tumor remnants. Design: The study design included historical cohort analysis of clinical results at two pituitary referral centers with different standard practices for postoperative NFPA management: DA therapy or conservative follow-up. Methods: Seventy-nine patients followed for 8.8 ± 6.5 years were treated with DA, initiated upon residual tumor detection on postoperative MRI (preventive treatment (PT) group, n = 55), or when tumor growth was subsequently detected during follow-up (remedial treatment (RT) group, n = 24). The control group (n = 60) received no medication. Tumoral dopamine and estrogen receptor expression assessed by quantitative RT-PCR and immunostaining were correlated with response to treatment. Results: Tumor mass decreased, remained stable, or enlarged, respectively, in 38, 49, and 13% of patients in the PT group, and in 0, 53, and 47% of control subjects; shrinkage or stabilization was achieved in 58% of enlarging tumors in the RT group, P < 0.0001. Fifteen-year progression-free survival rate was 0.805, 0.24, and 0.04, respectively, for PT, RT, and control groups (P < 0.001). About 42% of patients in the control group required additional surgery or radiotherapy, compared with 38 and 13% subjects in the RT and PT groups, respectively (P = 0.002). Outcome measures were not related to NFPA D2R abundance. Conclusions: Dopamine agonist therapy in patients with NFPA is associated with decreased prevalence of residual tumor enlargement after transsphenoidal surgical resection.

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“…This contrasts with effective drugs available (10,11) for the treatment of hormonesecreting pituitary tumors.…”

Section: Introductionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists

Greenman

Cooper

Yaish

et al. 2016

European Journal of Endocrinology

109

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“…The Endocrine Society clinical practice guidelines for acromegaly, and the Acromegaly Consensus Group, recommend IGF-I measurements rather than random GH values for diagnosis and treatment goals (2,3). In patients with GHD, IGF-I is also crucial for monitoring GH replacement therapy and for adjusting the GH dosage (4).…”

Section: Introductionmentioning

confidence: 99%

Classification of Patients With GH Disorders May Vary According to the IGF-I Assay

Mavromati¹,

Kuhn

Agostini

et al. 2017

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Successful therapy decreases symptoms related to GH excess such as soft tissue swelling [3]. Nevertheless, other acromegalic characteristics remain due to permanent changes, for example, in cartilage and bone.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in Acromegaly and the Association with the Clinical Parameters of the Disease

Papadakis¹

2017

EMIJ

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Background: Quality of life is currently considered a major factor in the assessment of disease outcome. Most patients with acromegaly present with skin, bone and soft tissue alterations, as well as hypertension, diabetes mellitus and other cardiovascular symptoms and all these affect patient's mood, personality, interpersonal relationships and social behavior. The aim of this study was to assess quality of life in acromegaly and the association with the clinical characteristics of the disease. Methods:This cross-sectional study included a total of 101 (45 male, 56 female) patients with acromegaly, mean age 59.51 ± 1.35 years (mean ± SEM), with a disease duration of 12.88 ± 0.96 years. All subjects completed the Acromegaly Quality of Life Questionnaire (AcroQoL). Results:Total (mean ± SEM) score was 86.15±1.37 (min22-max110), psychological parameters score was 54.98±0,95 (min 14-max 70), appearance score was 25.95±0.54 (min 7-max 35), personal relationship score was 29.37±0.52 (min7-max 35) and finally physical parameters score was 30.93±0.58 (min8-max 40). Women and older patients showed slightly worse scores. Patients with macroadenomas, those who received radiotherapy, and those with comorbidities appeared with less mean total QoL scores. Conclusion:The assessment of quality of life is a critical end point in the management of acromegaly and improvement of quality of life is a major aim in the therapeutic management of acromegaly.

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Expert consensus document: A consensus on the medical treatment of acromegaly

Cited by 322 publications

References 75 publications

Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists

Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists

Classification of Patients With GH Disorders May Vary According to the IGF-I Assay

Quality of Life in Acromegaly and the Association with the Clinical Parameters of the Disease

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