Determinants of clinical outcome and survival in acromegaly

Rajasoorya, C; Holdaway, I. M.; Wrightson, Philip; Scott, D.; Ibbertson, H. K.

doi:10.1111/j.1365-2265.1994.tb03789.x

Cited by 525 publications

(354 citation statements)

References 20 publications

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“…The reports cited below employ a mean fasting random GH plasma level of <2.5 μg/L as "safe" cutoff values for biochemical control. Achieving this value does not predict disease cure but correlates with reduced mortality for treated acromegaly patients (Rajasoorya et al, 1994). Moreover, relevant evidence suggests that the GH plasma nadir after a glucose load should be <1 μg/L (Holdaway et al, 2004) to reduce acromegaly-related mortality rates to those of the general population.…”

Section: Efficacy Of Long-acting Srif Analogs In Treating Acromegalymentioning

confidence: 99%

Somatostatin agonists for treatment of acromegaly

Ben-Shlomo

Melmed

2008

Molecular and Cellular Endocrinology

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The discovery of somatotropin-release inhibitory factor (SRIF) in hypothalamic extract in 1970 led to the synthesis of the first somatostatin analog octreotide, discovery of five somatostatin receptor subtypes, and development of additional somatostatin receptor ligands (SRL) as pharmacotherapy for acromegaly and other neuroendocrine tumors. Long-acting formulations of SRL (octreotide LAR Depot, lanreotide SR and lanreotide autogel) assure improved patient compliance with weekly up to monthly injections, and are commonly used as primary or adjuvant treatment of acromegaly. We review SRL currently available, emphasizing long-acting compounds and their efficacy in controlling acromegaly. Disease control is evaluated by biochemical markers, tumor shrinkage, and diseasesymptom improvement balanced against drug-related side effects.

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Section: Efficacy Of Long-acting Srif Analogs In Treating Acromegalymentioning

confidence: 99%

Somatostatin agonists for treatment of acromegaly

Ben-Shlomo

Melmed

2008

Molecular and Cellular Endocrinology

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“…2 Acromegaly is also associated with cardiovascular, cerebrovascular, metabolic, orthopaedic, ophthalmic and respiratory co-morbidities as well as increased rate of various malignancies, 4 which have a detrimental impact on patients' quality of life. many of these changes, in particular osteoarthritis, are irreversible even with correction of GH excess.…”

Section: Original Scientific Paper Original Research: Clinicalmentioning

confidence: 99%

“…1 This, coupled with insidious disease progress and non-specific symptoms, often leads to a marked delay in diagnosis, reported to range between 5 to 10 years after onset of symptoms. 2 Despite technological advancement in diagnostic methods to detect the disease, a delay in diagnosis continues to be 10.1071/HC15033 ABSTRACT IntroduCtIon: Chronic excess growth hormone production results in acromegaly, a condition associated with widespread physical changes, including soft tissue and bony overgrowth. When untreated, acromegaly reduces life expectancy.…”

Section: Introductionmentioning

confidence: 99%

Symptoms and signs of acromegaly: an ongoing need to raise awareness among healthcare practitioners

Zarool-Hassan

Conaglen

et al. 2016

J Prim Health Care

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INTRODUCTION Chronic excess growth hormone production results in acromegaly, a condition associated with widespread physical changes, including soft tissue and bony overgrowth. When untreated, acromegaly reduces life expectancy. Patients usually remain undiagnosed for years after the onset of symptoms, by which stage irreversible physical changes have often occurred. METHOD A cross-sectional questionnaire study involving patients with acromegaly from the Waikato Endocrine Unit and the New Zealand Acromegaly Society evaluated features of acromegaly that were present before diagnosis. The aim of this study was to identify acromegaly features that were most prevalent to promote increased awareness about the disease by healthcare providers. RESULTS 81 participants were included. The main pre-diagnosis physical changes participants reported were acral changes, alterations in facial features and oral symptoms. For some, these features were present for more than 10 years before the acromegaly diagnosis. Multiple co-morbidities associated with acromegaly were reported. Two-thirds of the participants felt that an earlier diagnosis was possible. Most participants were in contact with General Practitioners (GPs) and/or dentists before diagnosis. Endocrinologists had the highest diagnosis rate, followed by GPs. Dentists had a low diagnosis rate despite a high prevalence of oral symptoms among study participants. CONCLUSION Increased awareness of acromegaly among primary care clinicians is important as they are the first-point-of-contact with the healthcare system for most patients. Health professionals’ early recognition of symptoms and signs of acromegaly would reduce delays in time-to-diagnosis, enable earlier treatment and may improve outcomes for patients with acromegaly. MESH KEYWORDS Acromegaly; symptoms; delayed diagnosis; clinicians; primary healthcare

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“…Body mass index (BMI) was calculated according to the formula body weight (kg)/height (m) 2 . Waist and hip circumferences were measured by one observer by means of a steel tape.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 However, there are discrepancies in the prevalence of hypertension in acromegaly, among different authors it varies from 13% to 60%. 2,3 Hypertensive patients with acromegaly tend to be older and to suffer from the disease for a longer period of time than non-hypertensive acromegalic patients. Hypertension is usually mild, uncomplicated and readily responsive to drugs in acromegalic patients.…”

Section: Introductionmentioning

confidence: 99%

Altered circadian blood pressure profile in patients with active acromegaly. Relationship with left ventricular mass and hormonal values

Pietrobelli¹,

Akopian²,

Olivieri³

et al. 2001

J Hum Hypertens

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To determine the relationships between the circadian blood pressure profile and left ventricular mass, hormonal pattern and insulin sensitivity indices in patients with active acromegaly, ambulatory 24-h blood pressure monitoring (ABPM) was recorded in 25 subjects (47.0 ؎ 15.1 years, range 23-72). Serum growth hormone (GH) and insulin-like growth factor-1, fasting and mean plasma glucose and insulin during oral glucose tolerance test (OGTT), insulinogenic index, the sum of the plasma insulin levels and the homeostasis model insulin resistance index (Homa's index) were determined. Left ventricular mass index (LVMI) was calculated from two-dimensional guided M-mode echocardiogram. The prevalence of hypertension was 56% (n ‫؍‬ 14) and 40% (n ‫؍‬ 10) according to sphygmomanometric measurements and ABPM, respectively. Non-dipping profile was observed in six of 10 hypertensives and in

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Determinants of clinical outcome and survival in acromegaly

Abstract: Acromegaly has a significant adverse effect on well-being and survival. The predominant determinant of outcome is the final serum GH level following treatment.

Cited by 525 publications

References 20 publications

Somatostatin agonists for treatment of acromegaly

Somatostatin agonists for treatment of acromegaly

Symptoms and signs of acromegaly: an ongoing need to raise awareness among healthcare practitioners

Altered circadian blood pressure profile in patients with active acromegaly. Relationship with left ventricular mass and hormonal values

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