Endocrine Abstracts

Acromegaly is a disorder characterized by overproduction of growth hormones (GH), which causes tissue growth in the body and comorbidities and symptoms. While prior studies examined comorbidities commonly associated with acromegaly, few have long follow-up periods necessary to characterize the long-term comorbidity profile of patients with acromegaly. There is limited literature on real-world treatment patterns of patients with acromegaly. This study describes the long-term prevalence of comorbidities and symptoms associated with acromegaly, as well as treatment patterns, in a major referral center in Italy. Medical records of adult patients with a confirmed acromegaly diagnosis, ≥2 valid readings of GH and IGF1, and ≥6 months of follow-up at the endocrinology center at the University Federico II in Naples, Italy, were reviewed. For this analysis, patients were followed from the 1st acromegaly diagnosis recorded by this study center until end of data availability, loss to follow-up, or death; some patients may have had an earlier diagnosis before referral to this center. Prevalence (i.e., ≥1 diagnosis during chart review period) of selected comorbidities and symptoms was described. Treatments with corresponding line of therapy was documented during the follow-up period. 150 patients met the eligibility criteria. Patients were on average 43.1 years old (range: 19–70) at diagnosis, 47.3% female, all Caucasian, and median follow-up time was 8.7 years (range: 0.8–35.5). 25.3% of patients had ≥15 years of follow-up. The 3 most prevalent comorbidities were 1) endocrine and metabolic system disorders (97.3% of patients), 2) cardiovascular system disorders ([CVsD], 76.0%) and 3) arthropathy (62.0%). Common endocrine and metabolic system component conditions included dyslipidemia (74.7%), nodular thyroid disease (72.3%), glucose metabolism abnormalities (50.0%), gonadal and menstrual disorders (50.0%) and obesity (40.7%). CVsD’s component conditions included hypertension (59.3%), myocardial hypertrophy (50.0%) and other various CVsD’s (45.5%). Cancer, cerebrovascular disease, colon polyps, metabolic syndrome and sleep apnea were reported in <50% of patients. 68.0% of patients underwent transphenoidal surgery during the chart review period. 85.3% of patients received somatostatin analogs (e.g., lanreotide [58.7%] and octreotide (54.0%)) at various treatment phases. Dopamine agonists were used by 34.0% of patients, mostly in 2nd, 3rd or 4th line of therapy. Pegvisomant was used by 30.0% of patients, mostly in 2nd or 3rd line of therapy. While these comorbidities and symptoms have been shown to be associated with acromegaly, this study provides further insight on their lifetime prevalence. Heterogeneity in the treatment patterns underscores real-world differences in patient management following diagnosis.