Endocrine Abstracts

Acromegaly is associated with increased morbidity and premature mortality (predominantly due to vascular disease), but these effects can be reduced if GH levels are controlled (<2.5 µg/l) and IGF-1 levels are normalized. Confounding pituitary hormone deficiencies, particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Therapy for acromegaly is targeted at decreasing GH and IGF-1 levels, ameliorating patients’ symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, radiotherapy and medical therapies, such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant. Medical therapy is currently most widely used as secondary treatment for persistent or recurrent acromegaly following non-curative surgery, although it is increasingly used as primary therapy. These measures have resulted in increased life expectancy of patients with acromegaly over the past few decades.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.