Systemic Complications of Acromegaly and the Impact of the Current Treatment Landscape: An Update

Abstract

Acromegaly is a chronic systemic disease with many complications and is associated with increased mortality when not adequately treated. Significant advances in acromegaly treatment, as well as in the treatment of many of its complications, mainly diabetes mellitus, heart failure and arterial hypertension, were achieved in the last decades. These developments allowed change in both prevalence and severity of some acromegaly complications and furthermore resulted in a reduction of mortality. Nowadays, mortality seems to be similar to the general population in adequately treated patients with acromegaly. In this review, we will update the knowledge in complications of acromegaly and detail the effects of different acromegaly treatment options on these complications. Incidence of mortality, its correlation with growth hormone (cumulative exposure vs last value) and insulin-like growth factor type I levels and the shift in the main cause of mortality in patients with acromegaly will be also addressed.

Diagnostics and treatment of acromegaly — updated recommendations of the Polish Society of Endocrinology

“…The most recent reports say that life expectancy can indeed be restored in effectively treated patients with acromegaly [47,49]. This takes place in countries where early diagnostic evaluation and advanced therapies are more accessible.…”

“…Najnowsze doniesienia wskazują na przywrócenie oczekiwanej długości życia u skutecznie leczonych pacjentów z akromegalią [47,49]. Obserwacji tych dokonano w krajach, w których dostęp do wczesnej diagnostyki i nowoczesnych metod terapii jest ułatwiony.…”

Off-Label Use and Misuse of Testosterone, Growth Hormone, Thyroid Hormone, and Adrenal Supplements: Risks and Costs of a Growing Problem

“…Safety information from trials of GH replacement in deficient adults or even studies of GH administration in healthy younger or older adults cannot be extrapolated to individuals who abuse GH or IGF-1 in supraphysiologic doses and regimens, which can result in much higher drug exposures than those studied in clinical trials (7). Indeed, prolonged administration of GH in large doses may recapitulate acromegaly, a condition associated with increased risk of mortality in association with cardiovascular and neoplastic disorders, if inadequately treated (68,69,(76)(77)(78)(79).…”

An evaluation of the Acromegaly Treatment Satisfaction Questionnaire (Acro-TSQ) in adult patients with acromegaly, including correlations with other patient-reported outcome measures: data from two large multicenter international studies

“…Acromegaly is a rare hormonal disorder where excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are produced; it is most often caused by a benign tumor of the pituitary gland [1][2][3]. Patients can experience changes to their appearance and enlargement of hands and feet, as well as other symptoms and comorbidities [4]. First-line medical treatment is commonly somatostatin analogs (SSAs) [5][6][7] administered as either intramuscular (octreotide LAR) or deep subcutaneous injections (lanreotide depot); however, common side effects can include injection site reactions and gastrointestinal (GI) symptoms [8,9].…”