open access

Vol 68, No 5 (2017)
Original paper
Submitted: 2016-10-10
Accepted: 2016-11-22
Published online: 2017-07-06
Get Citation

Acromegaly treatment in Romania. How close are we to disease control?

Dan Alexandru Niculescu, Ionela Florina Baciu, Cristina Capatina, Simona Andreea Galoiu, Monica Livia Gheorghiu, Serban Radian, Raluca Alexandra Trifanescu, Andra Caragheorgheopol, Mihail Coculescu, Catalina Poiana
·
Pubmed: 28879646
·
Endokrynol Pol 2017;68(5):519-523.

open access

Vol 68, No 5 (2017)
Original Paper
Submitted: 2016-10-10
Accepted: 2016-11-22
Published online: 2017-07-06

Abstract

Introduction: In Romania, no nationwide data for acromegaly treatment and control rate are available. Our objective was to assess the acromegaly control rate in a tertiary referral centre, which covers an important part of Romanian territory and population of patients with acromegaly.

Materials and methods: We reviewed the records of all 164 patients (49 males and 115 females; median age 55 [47, 63.5] years) with newly or previously diagnosed acromegaly, who have been assessed at least once in our tertiary referral centre between January 1, 2012 and March 31, 2016. This sample represents 13.6% of the total expected 1200 Romanian patients with acromegaly and covers 82.9% of the counties in Romania. Control of acromegaly was defined as a random serum growth hormone (GH) < 1 ng/mL and an age-normalised serum insulin-like growth factor-I (IGF-I) value. The GH and IGF-I values used for calculation of the control rate were those at the last evaluation. The same assays for GH and IGF-I measurement were used in all patients.

Results: There were 147 treated and 17 untreated patients. Of the 147 patients assessed after therapy, 137 (93.2%) had pituitary surgery, 116 (78.9%) were on medical treatment at the last evaluation, and 67 (45.5%) had radiotherapy. Seventy-one (48.3%) had a random GH < 1 ng/mL, 54 (36.7%) had a normalised, age-adjusted IGF-I, and 42 (28.6%) had both normal random serum GH and IGF-I.

Conclusions: In Romania, acromegaly benefits from the whole spectrum of therapeutic interventions. However, the control rate remains disappointing.

Abstract

Introduction: In Romania, no nationwide data for acromegaly treatment and control rate are available. Our objective was to assess the acromegaly control rate in a tertiary referral centre, which covers an important part of Romanian territory and population of patients with acromegaly.

Materials and methods: We reviewed the records of all 164 patients (49 males and 115 females; median age 55 [47, 63.5] years) with newly or previously diagnosed acromegaly, who have been assessed at least once in our tertiary referral centre between January 1, 2012 and March 31, 2016. This sample represents 13.6% of the total expected 1200 Romanian patients with acromegaly and covers 82.9% of the counties in Romania. Control of acromegaly was defined as a random serum growth hormone (GH) < 1 ng/mL and an age-normalised serum insulin-like growth factor-I (IGF-I) value. The GH and IGF-I values used for calculation of the control rate were those at the last evaluation. The same assays for GH and IGF-I measurement were used in all patients.

Results: There were 147 treated and 17 untreated patients. Of the 147 patients assessed after therapy, 137 (93.2%) had pituitary surgery, 116 (78.9%) were on medical treatment at the last evaluation, and 67 (45.5%) had radiotherapy. Seventy-one (48.3%) had a random GH < 1 ng/mL, 54 (36.7%) had a normalised, age-adjusted IGF-I, and 42 (28.6%) had both normal random serum GH and IGF-I.

Conclusions: In Romania, acromegaly benefits from the whole spectrum of therapeutic interventions. However, the control rate remains disappointing.

Get Citation

Keywords

acromegaly, Romania, treatment, control rate

About this article
Title

Acromegaly treatment in Romania. How close are we to disease control?

Journal

Endokrynologia Polska

Issue

Vol 68, No 5 (2017)

Article type

Original paper

Pages

519-523

Published online

2017-07-06

Page views

1437

Article views/downloads

978

DOI

10.5603/EP.a2017.0041

Pubmed

28879646

Bibliographic record

Endokrynol Pol 2017;68(5):519-523.

Keywords

acromegaly
Romania
treatment
control rate

Authors

Dan Alexandru Niculescu
Ionela Florina Baciu
Cristina Capatina
Simona Andreea Galoiu
Monica Livia Gheorghiu
Serban Radian
Raluca Alexandra Trifanescu
Andra Caragheorgheopol
Mihail Coculescu
Catalina Poiana

References (17)
  1. Sherlock M, Ayuk J, Tomlinson JW, et al. Mortality in patients with pituitary disease. Endocr Rev. 2010; 31(3): 301–342.
  2. Melmed S, Colao A, Barkan A, et al. Acromegaly Consensus Group. Guidelines for acromegaly management: an update. J Clin Endocrinol Metab. 2009; 94(5): 1509–1517.
  3. Murray RD, Melmed S. A critical analysis of clinically available somatostatin analog formulations for therapy of acromegaly. J Clin Endocrinol Metab. 2008; 93(8): 2957–2968.
  4. Tritos NA, Biller BMK. Pegvisomant: a growth hormone receptor antagonist used in the treatment of acromegaly. Pituitary. 2017; 20(1): 129–135.
  5. Schöfl C, Franz H, Grussendorf M, et al. participants of the German Acromegaly Register. Long-term outcome in patients with acromegaly: analysis of 1344 patients from the German Acromegaly Register. Eur J Endocrinol. 2013; 168(1): 39–47.
  6. Bex M, Abs R, T'Sjoen G, et al. AcroBel--the Belgian registry on acromegaly: a survey of the 'real-life' outcome in 418 acromegalic subjects. Eur J Endocrinol. 2007; 157(4): 399–409.
  7. Howlett TA, Willis D, Walker G, et al. UK Acromegaly Register Study Group (UKAR-3). Control of growth hormone and IGF1 in patients with acromegaly in the UK: responses to medical treatment with somatostatin analogues and dopamine agonists. Clin Endocrinol (Oxf). 2013; 79(5): 689–699.
  8. Gheorghiu ML, Găloiu S, Vintilă M, et al. Beneficial effect of dose escalation and surgical debulking in patients with acromegaly treated with somatostatin analogs in a Romanian tertiary care center. Hormones (Athens). 2016; 15(2): 224–234.
  9. Sesmilo G, Gaztambide S, Venegas E, et al. REA investigators. Changes in acromegaly treatment over four decades in Spain: analysis of the Spanish Acromegaly Registry (REA). Pituitary. 2013; 16(1): 115–121.
  10. Kauppinen-Mäkelin R, Sane T, Reunanen A, et al. A nationwide survey of mortality in acromegaly. J Clin Endocrinol Metab. 2005; 90(7): 4081–4086.
  11. Katznelson L, Laws ER, Melmed S, et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014; 99(11): 3933–3951.
  12. Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary. 1999; 2(1): 29–41.
  13. Freda PU, Katznelson L, van der Lely AJ, et al. Long-acting somatostatin analog therapy of acromegaly: a meta-analysis. J Clin Endocrinol Metab. 2005; 90(8): 4465–4473.
  14. Laws ER. Surgery for acromegaly: evolution of the techniques and outcomes. Rev Endocr Metab Disord. 2008; 9(1): 67–70.
  15. Bates PR, Carson MN, Trainer PJ, et al. UK National Acromegaly Register Study Group (UKAR-2). Wide variation in surgical outcomes for acromegaly in the UK. Clin Endocrinol (Oxf). 2008; 68(1): 136–142.
  16. Erturk E, Tuncel E, Kiyici S, et al. Outcome of surgery for acromegaly performed by different surgeons: importance of surgical experience. Pituitary. 2005; 8(2): 93–97.
  17. Galoiu S. Mortality of Patients with Acromegaly FROM a Tertiary National Neuroendocrine Center. Acta Endocrinologica (Bucharest). 2015; 11(4): 476–481.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą jest  VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl