A Consensus on Criteria for Cure of Acromegaly

Abstract

Criteria to define active acromegaly and disease control were agreed, and several significant changes were made to the 2000 guidelines. Appropriate methods of measuring and achieving disease control were summarized.

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

“…Rigorous biochemical normalization 13 can be achieved by treating with SRLs in approximately 25% of unselected treatment-naive patients with acromegaly who were not previously shown to be responsive to an SRL. This figure is lower than those reported in previous guidelines and published papers that might have had patient selection bias due to the stringent inclusion and exclusion criteria required for clinical trials (MQ).…”

“…A 2011 consensus paper providing guidance on current GH and IGF-I assays stressed the importance of familiarity with appropriate hormone standards, specificity and sensitivity of the assay, and the need to determine assay-specific and method-specific normal GH cut-offs (SR). 12 We recommend that the aim of medical treatment is to reduce fasting morning GH and IGF-I concentrations to levels that are as close to normal as possible, following the recommendations of the previous consensus meeting held in 2009 (SR), 13 which were based on the existing epidemiological data. These studies should be updated using modern, sensitive and specific assays.…”

Case Report: A case report of acromegaly associated with primary aldosteronism

“…Acromegaly was well controlled on cabergoline 2×0.5 mg weekly. Hormonal parameters showed IGF-1 to be 20.1 nmol/l (normal range: 14–40.5), serum GH during OGTT was: 0 min 2.7 mUI/l; 60 min 1.6 mUI/l; 120 min 1.4 mUI/l (criteria for acromegaly control: basal GH<1 ng/ml (3 mIU/l) and <0.4 ng/ml (1.2 mIU/l) during OGTT 11 ). The last MRI of the pituitary gland, performed in 2010, did not show any enlargement of the existing tumor remnant.…”

Análise da expressão da filamina A nos tumores hipofisários e suas implicações clínicas e terapêuticas

“…A dosagem basal de GH menor do que 0,4 ng/mL, associada à dosagem de IGF-1 normal para idade, excluem o diagnóstico de acromegalia, enquanto que, níveis de GH acima de 0,4 ng/mL no basal e que não suprimem para valores menores que 0,4 ng/mL no TTGO, associados a níveis elevados de IFG-1, confirmam a condição (66) .…”

“…O controle hormonal é caracterizado por níveis de GH randômicos menores do que 1 ng/mL e níveis normais de IGF-1 para idade (66,67) .…”