Patient Characteristics, Diagnostic Delays, Treatment Patterns, Treatment Outcomes, Comorbidities, and Treatment Costs of Acromegaly in China: A Nationwide Study

Abstract

PurposeAcromegaly is a rare, intractable endocrine disease. We aimed to describe the patient characteristics, diagnostic delays, treatment patterns, treatment outcomes, comorbidities and treatment costs of acromegaly in China.MethodsThis is a nationwide cross-sectional study. Patients diagnosed with and treated for acromegaly between 1996 and 2019 across China were surveyed via the Chinese Association of Patients with Acromegaly platform.ResultsIn total, 473 patients (58.8% females, mean age at diagnosis: 39.4±9.5 years) were included. The median disease duration was 3 years. The most common symptoms were extremity enlargement (91.8%) and facial changes (90.1%). Overall, 63.0% of patients experienced diagnostic delays within healthcare systems; 63.8% of the delays were <1 year. The most common first-line therapy was surgery with a transsphenoidal (76.1%) or transcranial approach (3.2%). Somatostatin analogues or dopamine agonists were administered in 20.5% of the patients as first-line therapies and in 41.7% as adjuvant therapies. Radiotherapy was performed in 32.1% of patients, 99.3% of whom received radiotherapy as an adjuvant therapy. After a median 5-year follow-up, 46.2% achieved biochemical control. Comorbidities were reported in 88.2% of the patients at follow-up; memory deterioration and thyroid nodules were the most common. Controlled patients had greater improvements in symptoms and comorbidities during follow-up than uncontrolled patients. The annual per-capita cost-of-treatment was $11013 in 2018, with medical treatments being the largest contributor (67%). Medical insurance covered 47.2% of all treatment costs.ConclusionThis study provides the first comprehensive description of real-world acromegaly data in China, serving as a basis for future population-based studies.

Correlation Between Clinical and Biochemical Markers in Patients With Acromegaly on Different Modalities of Treatment

“…On the other hand, some studies confirm an improvement in clinical complaints and HrQoL after biochemical control. For example, in 2020, a Chinese study concluded that there is improvement in patients’ symptoms and HrQoL after patients' control [ 21 ]. However, despite the statistically significant reduction in their symptom frequency after biochemical control, the persistence of these symptoms was demonstrated in a significant proportion.…”

Oral Manifestations and Maxillo-Facial Features in the Acromegalic Patient: A Literature Review

“…Acromegaly prevalence ranges from 20 to 130 people per million inhabitants [2,4,[7][8][9][10][11][12][13][14][15], with an annual incidence of 2 to 11 cases per million people [4,[7][8][9][10]13,15]. Most studies show that there are no sex differences in acromegaly prevalence [2,4,6,16]; however, some studies have shown a slightly higher prevalence among women [12].…”

“…Acromegaly is a rare chronic disease caused by an excessive secretion of growth hormone (GH), mostly due to an adenoma of the anterior pituitary gland and resulting in an increased circulating concentration of insulin-like growth factor 1 (IGF-1), the main effector of GH activity. It is characterized by a slow progression of signs and symptoms and multisystemic involvement, leading to physical alterations, progressive somatic changes, and a complex range of systemic comorbidities [1][2][3][4][5][6][7][8][9][10].…”

Разходи За Лечение На Съпътстващи Заболявания При Пациенти С Акромегалия – Преглед На Литературата

“…Броят на публикуваните проучвания е ограничен, като от всички идентифицирани 176 проучвания само 16 отговарят на изследователския въпрос. Повечето публикувани проучва-ния са проведени в САЩ (n=6) [20,23,24,26,29,32], следвани от Канада (n=2) [17,21], Швеция (n=2) [25,28], Китай (n=1) [31], Испания (n=1) [22], Италия (n=1) [18], Полша (n=1) [27]. Две от идентифицираните проучвания представляват систематичен преглед [19,30].…”