MANAGEMENT OF ENDOCRINE DISEASE: Bone disorders associated with acromegaly: mechanisms and treatment

Mazziotti, Gherardo; Lania, Andrea; Canalis, Ernesto

doi:10.1530/eje-19-0184

Cited by 51 publications

(48 citation statements)

References 131 publications

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“…Biochemically active disease is generally associated with a higher risk of vertebral fractures (VF) [19,24]. One study [25] involved 55 patients treated with pasireotide long acting release (LAR) or pegvisomant who had been previously uncontrolled on octreotide LAR or lanreotide for at least 6 months, 42% of whom had VFs at baseline.…”

Section: What's Newmentioning

confidence: 99%

A Pituitary Society update to acromegaly management guidelines

et al. 2020

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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.

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Section: What's Newmentioning

confidence: 99%

A Pituitary Society update to acromegaly management guidelines

et al. 2020

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“…This seems paradoxical given that IGFs are required for normal bone development [76]. However, excess IGF-1 secretion has been shown to compromise bone integrity and microstructure, leading to increased risk of vertebral fracture [77]. IGFs are also important for the growth and survival of cardiomyocytes, and untreated acromegaly can cause hypertrophic cardiomyopathy leading to cardiac failure [78].…”

Section: Disease States Characterized By Igf Axis Activationmentioning

confidence: 99%

Therapeutic Targeting of the IGF Axis

Osher

Macaulay

2019

Cells

128

124

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The insulin like growth factor (IGF) axis plays a fundamental role in normal growth and development, and when deregulated makes an important contribution to disease. Here, we review the functions mediated by ligand-induced IGF axis activation, and discuss the evidence for the involvement of IGF signaling in the pathogenesis of cancer, endocrine disorders including acromegaly, diabetes and thyroid eye disease, skin diseases such as acne and psoriasis, and the frailty that accompanies aging. We discuss the use of IGF axis inhibitors, focusing on the different approaches that have been taken to develop effective and tolerable ways to block this important signaling pathway. We outline the advantages and disadvantages of each approach, and discuss progress in evaluating these agents, including factors that contributed to the failure of many of these novel therapeutics in early phase cancer trials. Finally, we summarize grounds for cautious optimism for ongoing and future studies of IGF blockade in cancer and non-malignant disorders including thyroid eye disease and aging.

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“…Previous research showed a controversial effect of excess GH/IGF-I on trabecular and cortical bone in acromegaly [36]. Kuzma et al [37] published the first study using 3D-SHAPER software in acromegaly and found that regardless of the presence of vertebral fractures, acromegaly patients had less trabecular bone, while cortical density was only decreased in those with vertebral fractures.…”

Section: Cortical and Trabecular Bone Differences Assessed By 3d-dxamentioning

confidence: 99%

3D DXA Hip Differences in Patients with Acromegaly or Adult Growth Hormone Deficiency

Gracia‐Marco

González-Salvatierra

García-Martín

et al. 2021

JCM

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The skeleton is regulated by and responds to pituitary hormones, especially when the circulating levels are perturbed in disease. This study aims to analyse the between-group differences in 3D dual-energy X-ray absorptiometry (DXA) parameters at the hip site among patients with acromegaly or adult growth hormone deficiency (AGHD) and a healthy control group. The current cross-sectional study includes data for 67 adults, 20 with acromegaly, 14 with AGHD and 33 healthy controls. We obtained the areal bone mineral density (aBMD) outcomes using DXA and cortical and trabecular parameters using 3D-DXA software (3D-SHAPER). The mean-adjusted 3D-DXA parameters did not differ between acromegaly patients and the controls (p > 0.05); however, we found cortical bone impairment (−7.3% to −8.4%; effect size (ES) = 0.78) in AGHD patients (p < 0.05). Differences in the cortical bone parameters were more evident when comparing AGHD patients (−8.5% to −16.2%; ES = 1.22 to 1.24) with acromegaly patients (p < 0.05). In brief, the 3D mapping highlighted the trochanter as the site with greater cortical bone differences between acromegaly patients and the controls. Overall, AGHD patients displayed lower cortical parameters at the trochanter, femoral neck and intertrochanter compared to the controls and acromegaly patients. To sum up, 3D-DXA provided useful information about the characteristics of bone involvement in growth hormone (GH)-related disorders. Patients with AGHD showed distinct involvement of the cortical structure.

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MANAGEMENT OF ENDOCRINE DISEASE: Bone disorders associated with acromegaly: mechanisms and treatment

Cited by 51 publications

References 131 publications

A Pituitary Society update to acromegaly management guidelines

A Pituitary Society update to acromegaly management guidelines

Therapeutic Targeting of the IGF Axis

3D DXA Hip Differences in Patients with Acromegaly or Adult Growth Hormone Deficiency

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