Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

Dal, Jakob; Feldt‐Rasmussen, Ulla; Andersen, Marianne; Kristensen, Lars Østergaard; Laurberg, Peter; Pedersen, Lars; Dekkers, Olaf M.; Sørensen, Henrik Toft; Jørgensen, Jens Otto Lunde

doi:10.1530/eje-16-0117

Cited by 173 publications

(180 citation statements)

References 46 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…Raappana et al [8] obtained information from Oulu University Hospital in which the great majority of patients with pituitary tumor from the four northernmost provinces of Finland are referred. Dal et al [9] covered the entire population of Denmark and obtained data from the Danish National Patient Registry, the Danish Civil Registration System and the Danish Register of Causes of Death. Bex et al [10] collected information on patients with acromegaly through a nationwide survey involving all endocrinologists managing patients with pituitary disorders in Belgium and the Grand Duchy of Luxembourg (the University Hospital of Liege and some local centers did not take part).…”

Section: Epidemiology Of Acromegalymentioning

confidence: 99%

Epidemiology of acromegaly: review of population studies

et al. 2016

View full text Add to dashboard Cite

Acromegaly is a rare condition necessitating large population studies for the generation of reliable epidemiological data. In this review, we systematically analysed the epidemiological profile of this condition based on recently published population studies from various geographical areas. The total prevalence ranges between 2.8 and 13.7 cases per 100,000 people and the annual incidence rates range between 0.2 and 1.1 cases/100,000 people. The median age at diagnosis is in the fifth decade of life with a median diagnostic delay of 4.5–5 years. Acral enlargement and coarse facial features are the most commonly described clinical manifestations. At the time of detection, most of the tumors are macroadenomas possibly relating to diagnostic delays and posing challenges in the surgical management. Increased awareness of acromegaly amongst the medical community is of major importance aiming to reduce the adverse sequelae of late diagnosis and treatment, improve patient outcomes and, hopefully, reduce the burden on the health care system.

show abstract

Section: Epidemiology Of Acromegalymentioning

confidence: 99%

Epidemiology of acromegaly: review of population studies

et al. 2016

View full text Add to dashboard Cite

show abstract

“…However, the mortality was only increased during the first time period (1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995) suggesting a decrease of mortality over time (13) (Erratum published in January 2019 https://doi.org/10.1530/EJE-18-0015e). Of interest, in a modern Danish cohort, overall mortality risk was still increased, but only with about 30% compared to the background population, again primarily due to an increased cardiovascular mortality (17). Conversely, in the French Registry of Acromegaly, life expectancy was close to the general population, SMR 1.05 (95% CI: 0.70-1.42), and cancer occurred just in 10% of patients, but most deaths were related to malignancies (18).…”

Section: Epidemiologymentioning

confidence: 98%

MANAGEMENT OF ENDOCRINE DISEASE: Individualised management of acromegaly

Bollerslev

Heck

Olarescu

2019

European Journal of Endocrinology

View full text Add to dashboard Cite

Acromegaly is a rare and challenging disease calling for management in highly specialised multidisciplinary teams (MDTs). Untreated disease has severe morbidity and a clearly increased mortality. Major attainments have been gained over the latest decades, and therefore, the aim of this review is to discuss recent achievements in modern multimodal therapy of acromegaly performed by MDTs, with an emphasis on an individualised, proactive management from the time of diagnosis to long-term outcome. Treatment by surgery is the only potential curative treatment, however, even with modern techniques still with modest cure rates, leaving the patients to often long-term medical treatment. Treatment strategies have changed dramatically in the Western world over recent years, implying a more proactive treatment algorithm often with a shorter or longer pre-surgical treatment period with somatostatin receptor ligands (SRLs). Not all patients will however respond to primary treatment with conventional SRLs and there has recently been a development of potential biomarkers for response that has been implemented in the clinical routine. By today, multimodal treatment can bring every patient in remission, but still almost a third of all patients are undertreated according to large, international registries. On the other hand, it might be a challenge not to over treat thereby bringing the patient into a state of relative or absolute growth hormone deficiency. Clinical series published during the last decade on treatment of patients with acromegaly have indicated a normalisation of mortality, most probably reflecting the proactive and individualised modern treatment. In conclusion, modern, multimodal treatment seems to have normalised mortality, but still the patients suffer from a high multi-organ morbidity and often multipharmacy. Every patient should receive an individualised, proactive treatment in order to improve long-term outcome and to reduce costs for the society.Correspondence should be addressed to J Bollerslev . His special interest is within clinical and translational endocrinology, and in particular, in classical endocrine diseases, such as acromegaly and Cushing's, often studying bone as target tissues for clinical activity. A major topic has been clinical management of acromegaly, and especially searching for biomarkers for responsiveness to medical therapy. Prospectively collected data of newly diagnosed patients with acromegaly has been the background for current studies of individualised, multimodal and transdisciplinary treatment. European Journal of Endocrinology 181:2 R60 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R61 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R63 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R64 Review J Bollerslev and others Managing acromegaly https://eje.bioscie...

show abstract

“…Symptoms related to these co-morbidities are the most likely reason for undiagnosed patients with acromegaly to seek medical attention (Katznelson et al 2011). Mortality rate is increased in acromegaly, with standardized mortality ratios relative to the general population ranging from 1.3 to 1.9 , Ritvonen et al 2015, Dal et al 2016, which is further elevated if co-morbidities, particularly cardiovascular disease, are present (Sherlock et al 2010). The clinical burden of acromegaly is further compounded by the substantial impairment in quality of life (QoL) (Rowles et al 2005, Trepp et al 2005, T'Sjoen et al 2007.…”

Section: Acromegaly: Backgroundmentioning

confidence: 99%

Somatostatin analogues in acromegaly and gastroenteropancreatic neuroendocrine tumours: past, present and future

Öberg¹,

Lamberts²

2016

Endocrine-Related Cancer

View full text Add to dashboard Cite

Acromegaly is a hormonal disorder that arises when the pituitary gland secretes excess growth hormone (GH), which in turn stimulates a concomitant increase in serum insulin-like growth factor 1 (IGF-1) levels. Gastroenteropancreatic neuroendocrine tumours (GEP-NET) constitute a heterogeneous group of tumours that can secrete serotonin and a variety of peptide hormones that may cause characteristic symptoms known as carcinoid syndrome or other symptoms and hormonal hypersecretion syndromes depending on the tumour's site of origin. Current medical therapy for the treatment of acromegaly and GEP-NET involves the administration of somatostatin analogues that effectively suppress excess hormone secretion. After its discovery in 1979, octreotide became the first synthetic biologically stable somatostatin analogue with a short-acting formulation of octreotide introduced into clinical practice in the late 1980s. Lanreotide, another somatostatin analogue, became available in the mid-1990s initially as a prolonged-release formulation administered every 10 or 14 days. Long-acting release formulations of both octreotide (Sandostatin LAR and Novartis) and lanreotide (Somatuline Autogel, Ipsen), based on microparticle and nanoparticle drug-delivery technologies, respectively, were later developed, which allowed for once-monthly administration and improved convenience. First-generation somatostatin analogues remain one of the cornerstones of medical therapy in the management of pituitary and GEP-NET hormone hypersecretion, with octreotide having the longest established efficacy and safety profile of the somatostatin analogue class. More recently, pasireotide (Signifor), a next-generation multireceptor-targeted somatostatin analogue, has emerged as an alternative therapeutic option for the treatment of acromegaly. This review summarizes the development and clinical success of somatostatin analogues.

show abstract

Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

Cited by 173 publications

References 46 publications

Epidemiology of acromegaly: review of population studies

Epidemiology of acromegaly: review of population studies

MANAGEMENT OF ENDOCRINE DISEASE: Individualised management of acromegaly

Somatostatin analogues in acromegaly and gastroenteropancreatic neuroendocrine tumours: past, present and future

Contact Info

Product

Resources

About