Acromegaly is a rare chronic, systemic disorder caused by excessive
growth hormone (GH) secretion from a somatotroph
pituitary adenoma. GH hypersecretion leads to overproduction of
insulin-like growth factor-1 (IGF-1), which contributes to the somatic overgrowth, physical disfigurement, onset of multiple systemic comorbidities, reduced quality of life (QoL) and premature mortality of uncontrolled patients.
Somatostatin receptor ligands,
dopamine agonists and a GH receptor antagonist are currently available for medical
therapy of
acromegaly. The main aim of treatment is biochemical normalisation, defined as age-normalised serum
IGF-1 values and random GH levels <1.0 μg/L. However, there is an increasing evidence suggesting that achieving biochemical control does not always decrease the burden of disease-related comorbidities and/or improve patients' QoL. This lack of correlation between biochemical and clinical control can be due to both disease duration (late diagnosis) or to the peculiarity of a given comorbidity. Herein we conducted ad hoc literature searches in order to find the most recent and relevant reports on biochemical and clinical disease control during medical treatment of
acromegaly. Particularly, we analyse and describe the relationship between biochemical, as well as clinical disease control in patients with
acromegaly receiving medical
therapy, with a focus on comorbidities and QoL. In conclusion, we found that current literature data seem to indicate that clinical disease control (besides biochemical control), encompassing clinical signs and symptoms, comorbidities and QoL, emerge as a primary focus of
acromegaly patient management.