open access

Vol 71, No 3 (2020)
Original Paper
Published online: 2020-04-15
Submitted: 2020-01-15
Accepted: 2020-03-22
Get Citation

Improvement of acromegaly control with multimodal therapy in Romania

Mihai C. Marinescu, Ionela Baciu, Nicoleta Baculescu, Cristina A.-M. Capatina, Roxana Dusceac, Simona Galoiu, Dan A. Niculescu, Serban Radian, Raluca A. Trifanescu, Maria C. Baleanu, Andra Caragheorgheopol, Catalina Poiana
DOI: 10.5603/EP.a2020.0020
·
Pubmed: 32293700
·
Endokrynologia Polska 2020;71(3):235-239.

open access

Vol 71, No 3 (2020)
Original Paper
Published online: 2020-04-15
Submitted: 2020-01-15
Accepted: 2020-03-22

Abstract

Introduction: In Romania, there is no acromegaly national register and there are no nationwide data available. However, some studies have reported the control rates in the country’s main referral centres. Our aim was to assess the overall control rate in our tertiary referral centre. Also, we assessed the control rate in the last three years, and we compared the results with our previous reports.

Material and methods: We reviewed the charts of 186 patients with acromegaly assessed in our department between January 1st, 2012 and May 31st, 2019. We also compared the control rates for patients treated between April 1st, 2016 and May 31st, 2019 with historical controls (assessed between January 1st, 2012 and March 31st, 2016).

Results: Primary analysis: There were 19 untreated and 167 treated patients, mean age 52.46 years, surgery being the most commonly used treatment. The surgical cure rate was 14.8%, and disease control with medical treatment was 35.3%. Secondary analysis: In the first group there were 45 patients, surgery also being the most commonly used treatment. The surgical cure rate was 26.9%, and disease control was 30.4%. In the second group (historical controls) there were 42 patients, surgery being the most commonly used treatment. The surgical cure rate was 9.7%, and disease control with medical treatment was 15.4%. Random GH and IGF-1 after surgery were lower in the first group (p < 0.05)

Conclusions: Changes in the Romanian protocol and highly specialised pituitary centres has improved the cure rate and disease control in patients with acromegaly. 

Abstract

Introduction: In Romania, there is no acromegaly national register and there are no nationwide data available. However, some studies have reported the control rates in the country’s main referral centres. Our aim was to assess the overall control rate in our tertiary referral centre. Also, we assessed the control rate in the last three years, and we compared the results with our previous reports.

Material and methods: We reviewed the charts of 186 patients with acromegaly assessed in our department between January 1st, 2012 and May 31st, 2019. We also compared the control rates for patients treated between April 1st, 2016 and May 31st, 2019 with historical controls (assessed between January 1st, 2012 and March 31st, 2016).

Results: Primary analysis: There were 19 untreated and 167 treated patients, mean age 52.46 years, surgery being the most commonly used treatment. The surgical cure rate was 14.8%, and disease control with medical treatment was 35.3%. Secondary analysis: In the first group there were 45 patients, surgery also being the most commonly used treatment. The surgical cure rate was 26.9%, and disease control was 30.4%. In the second group (historical controls) there were 42 patients, surgery being the most commonly used treatment. The surgical cure rate was 9.7%, and disease control with medical treatment was 15.4%. Random GH and IGF-1 after surgery were lower in the first group (p < 0.05)

Conclusions: Changes in the Romanian protocol and highly specialised pituitary centres has improved the cure rate and disease control in patients with acromegaly. 

Get Citation

Keywords

acromegaly; control rate; treatment

About this article
Title

Improvement of acromegaly control with multimodal therapy in Romania

Journal

Endokrynologia Polska

Issue

Vol 71, No 3 (2020)

Pages

235-239

Published online

2020-04-15

DOI

10.5603/EP.a2020.0020

Pubmed

32293700

Bibliographic record

Endokrynologia Polska 2020;71(3):235-239.

Keywords

acromegaly
control rate
treatment

Authors

Mihai C. Marinescu
Ionela Baciu
Nicoleta Baculescu
Cristina A.-M. Capatina
Roxana Dusceac
Simona Galoiu
Dan A. Niculescu
Serban Radian
Raluca A. Trifanescu
Maria C. Baleanu
Andra Caragheorgheopol
Catalina Poiana

References (21)
  1. Melmed S, Bronstein MD, Chanson P, et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018; 14(9): 552–561.
  2. Haliloglu O, Kuruoglu E, Ozkaya HM, et al. Multidisciplinary Approach for Acromegaly: A Single Tertiary Center's Experience. World Neurosurg. 2016; 88: 270–276.
  3. Cerit ET, Ağbaht K, Demir Ö, et al. Discordane between GH and IGF-1 levels in Turkish acromegalic patients. Endocr Pract. 2016; 22(12): 1422–1428.
  4. Anagnostis P, Efstathiadou ZA, Polyzos SA, et al. Acromegaly: presentation, morbidity and treatment outcomes at a single centre. Int J Clin Pract. 2011; 65(8): 896–902.
  5. Karapanou O, Tzanela M, Christoforaki M, et al. Therapeutic trends and outcome of acromegaly: a single center experience over a 40-year period. Hormones (Athens). 2016; 15(3): 368–376.
  6. 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.
  7. Portocarrero-Ortiz LA, Vergara-Lopez A, Vidrio-Velazquez M, et al. Mexican Acromegaly Registry Group. The Mexican Acromegaly Registry: Clinical and Biochemical Characteristics at Diagnosis and Therapeutic Outcomes. J Clin Endocrinol Metab. 2016; 101(11): 3997–4004.
  8. Vallette S, Ezzat S, Chik C, et al. Emerging trends in the diagnosis and treatment of acromegaly in Canada. Clin Endocrinol (Oxf). 2013; 79(1): 79–85.
  9. Maione L, Brue T, Beckers A, et al. French Acromegaly Registry Group. Changes in the management and comorbidities of acromegaly over three decades: the French Acromegaly Registry. Eur J Endocrinol. 2017; 176(5): 645–655.
  10. 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.
  11. Esposito D, Ragnarsson O, Granfeldt D, et al. Decreasing mortality and changes in treatment patterns in patients with acromegaly from a nationwide study. Eur J Endocrinol. 2018; 178(5): 459–469.
  12. 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.
  13. Bollerslev J, Heck A, Olarescu NC. Management of endocrine disease: Individualized Management of Acromegaly. Eur J Endocrinol. 2019; 181(2): R57–R71.
  14. Valea A, Ghervan C, Carsote M, et al. Effects of combination therapy: somatostatin analogues and dopamine agonists on GH and IGF1 levels in acromegaly. Clujul Med. 2015; 88(3): 310–313.
  15. Kun I, Tanko Z, Nasalean A, et al. Multimodal management of GH-secreting pituitary adenomas — the experience of the endocrinology department Tirgu-Mures, Romania, in the last decade. Endocrine Abstracts. 2015.
  16. Niculescu DA, Baciu IF, Capatina C, et al. Acromegaly treatment in Romania. How close are we to disease control? Endokrynol Pol. 2017; 68(5): 519–523.
  17. 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.
  18. 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.
  19. Vandeva S, Elenkova A, Natchev E, et al. Treatment outcome results from the Bulgarian Acromegaly Database: adjuvant dopamine agonist therapy is efficient in less than one fifth of non-irradiated patients. Exp Clin Endocrinol Diabetes. 2015; 123(1): 66–71.
  20. Buchfelder M, Schlaffer SM. The surgical treatment of acromegaly. Pituitary. 2017; 20(1): 76–83.
  21. Kauppinen-Makelin R, Sane T, Reunanen A, et al. A nationwide survey of mortality in acromegaly. J Clin Endocrinol Metab. 2005 ; 90(7): 4081–4086.

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 serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

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