Endocrine Abstracts

Background: The registry is the main source of information about patients with acromegaly for assessing the quality of medical care, effectiveness of treatment, determining the compliance of real clinical practice with existing standards and patient management protocols.

Aims: To analyze the epidemiological, demographic and clinical characteristics of acromegaly in the Russian Federation and the effectiveness of various treatment methods.

Materials and methods: The object of the study was the database of the united Russian registry of patients with pituitary tumors with specific analysis of patients with acromegaly only. We analyzed 4114 patients with acromegaly included in the online system by February 2019.

Results: Based on the data collected by February 2019 32% of patients had complete clinical and laboratory remission of the disease; the percentage of patients with no remission was 68%, among them 22.5% had significant improvements in clinical presentations and decrease in GH and IGF1 without IGF1 normalization. The average age of patients at the onset of the disease was 42.7 years, at the stage of diagnosis – 45.8 years. The ratio of men to women was 1:2.6.Among patients with acromegaly and hypopituitarism complications such as hypothyroidism (66%) and hypogonadism (52%) were registered more often followed by secondary diabetes mellitus (15.7%) and acromegalic arthropathy (15%). The proportion of patients receiving neurosurgical treatment increased from 35.7% to 49.6% in 2012 – 2019; the percentage of patients undergoing radiation therapy decreased significantly from 17.7% in 2012 to 0.8% in 2019. Remission was achieved in 40.47% after neurosurgery and 28.95% after medical treatment as a first line therapy P < 0.01. The number of patients receiving medical treatment at the time of the study was 1209. Among them 51% of patients being treated with long-acting lanreotide and 24% receiving long-acting octreotide achieved remission (P < 0.0001)

Conclusions: Remission of acromegaly remains suboptimal despite increased surgical activity, which corresponds to global trends. Long-acting lanreotide was significantly superior versus long-acting octreotide in the rate of acromegaly remission, which does not correspond with clinical trials and can be explained by the generic forms, regional differences in medical supply and demand towards medical nurse qualification with regards to the injection of long-acting octreotide.