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Acromegaly

A condition caused by prolonged exposure to excessive HUMAN GROWTH HORMONE in adults. It is characterized by bony enlargement of the FACE; lower jaw (PROGNATHISM); hands; FEET; HEAD; and THORAX. The most common etiology is a GROWTH HORMONE-SECRETING PITUITARY ADENOMA. (From Joynt, Clinical Neurology, 1992, Ch36, pp79-80)

Also Known As:

Inappropriate GH Secretion Syndrome (Acromegaly); Hypersecretion Syndrome, Somatotropin (Acromegaly); Hypersecretion Syndromes, Somatotropin (Acromegaly); Somatotropin Hypersecretion Syndromes (Acromegaly); Syndrome, Somatotropin Hypersecretion (Acromegaly); Syndromes, Somatotropin Hypersecretion (Acromegaly); Inappropriate Growth Hormone Secretion Syndrome (Acromegaly); Somatotropin Hypersecretion Syndrome (Acromegaly)

Networked: 3656 relevant articles (401 outcomes, 480 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Neoplasms (Cancer)
2.	Pituitary Neoplasms (Pituitary Adenoma)
3.	Prolactinoma (Prolactinomas)
4.	Adenoma (Adenomas)
5.	Hypopituitarism (Sheehan's Syndrome)

Experts

1.	Colao, Annamaria: 60 articles (08/2015 - 03/2002)
2.	Colao, A: 44 articles (10/2015 - 01/2000)
3.	Pivonello, Rosario: 40 articles (08/2015 - 07/2002)
4.	Chanson, Philippe: 34 articles (12/2015 - 01/2005)
5.	Lombardi, G: 34 articles (12/2012 - 01/2000)
6.	Lombardi, Gaetano: 33 articles (09/2013 - 03/2002)
7.	Trainer, P J: 30 articles (04/2012 - 04/2000)
8.	Giustina, Andrea: 26 articles (04/2015 - 01/2002)
9.	Melmed, Shlomo: 26 articles (04/2015 - 01/2002)
10.	van der Lely, A J: 24 articles (11/2015 - 04/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Acromegaly:

1.	Insulin-Like Growth Factor I (IGF-1)IBA 01/01/2011 - "The results of the second postoperative week, 3 months postoperative, and the most recent follow-up OGTT and IGF-1 measurements were used to calculate the positive and negative predictive values of the following endocrinological criteria of acromegaly remission: the common consensus criteria for acromegaly remission, GH suppression to < 1 μg/l during OGTT and IGF-1 within normal limits. " 12/01/2002 - "Definitive remission of acromegaly was considered to be present if, without adjuvant therapy and at the most recent follow-up examination, GH was suppressed to less than 1 microg/L during the OGTT, the level of insulin-like growth factor-I (IGF-I) was within normal limits, and there was no clinical or magnetic resonance imaging evidence of persisting disease. " 06/01/2001 - "In conclusion, long-term treatment with OCT-LAR was effective in controlling GH and IGF-I hypersecretion in most patients with acromegaly, when applied either as primary therapy or as adjunctive therapy after surgery. " 05/01/2000 - "However, recent evidence has suggested that RT is not curative in most patients with acromegaly when normalization of the serum insulin-like growth factor I (IGF-I) level is used to define remission. " 03/01/1987 - "The clinical and metabolic parameters of acromegaly dramatically improved in all patients whose plasma GH and somatomedin-C levels decreased even if they were not normalized by SMS. "
2.	Octreotide (Sandostatin)FDA LinkGeneric 05/01/2009 - "This first randomized study in unselected patients indicates that the 48-week treatment outcome of octreotide LAR as first-line treatment of acromegaly does not significantly differ from surgery. " 08/01/2009 - "High-dose octreotide treatment is safe and effective (normalisation of IGF1 levels) in a subset of patients with active acromegaly inadequately controlled with long-term SSA. " 07/01/2010 - "Critical appraisal of a randomized trial: surgery is superior to octreotide LAR in newly diagnosed patients with acromegaly." 10/01/2000 - "Octreotide LAR proved effective for the treatment of acromegaly and was well tolerated. " 11/01/1995 - "Sandostatin-LAR is an effective and well-tolerated treatment for patients with acromegaly. "
3.	Somatostatin (Somatotropin Release-Inhibiting Factor)IBA 06/01/2014 - "Somatostatin analogs improved GH/IGF-1 levels in most patients but achieved control of acromegaly in only 17 (30%) of 56 patients. " 08/01/2008 - "Partial control in disease activity following somatostatin analogues results in significant improvement in a considerable number of cardiovascular risk markers in acromegaly." 06/01/2006 - "Surgical remission and complication rates in patients with acromegaly who received treatment with somatostatin analogs prior to surgery were not significantly different from those of matched patients who did not receive these agents. " 07/01/2004 - "Patients with active acromegaly or under somatostatin analogs therapy had significant higher serum PSA concentration than controls, while patients in remission after adenomectomy did not differ. " 03/05/2007 - "Traditional treatment of acromegaly comprises surgery and somatostatin analogs (SA), which however is effective in no more than 80%. "
4.	Growth Hormone (Somatotropin)IBA 05/01/1990 - "Somatotropin pulse frequency and basal concentrations are increased in acromegaly and are reduced by successful therapy." 04/01/1983 - "Following successful treatment of acromegaly (growth hormone less than 5 micrograms/l) there was a significant reduction in skin thickness (P less than 0.02 males: P less than 0.01 females). " 10/01/1995 - "Treatment of acromegaly is effective in reversing the reduced life-span of patients only when serum growth hormone (GH) concentrations are lowered to less than 2.5 micrograms/l. " 08/01/1990 - "Eleven of 15 patients (73%) had growth hormone levels less than 10 ng/ml. Radiation use in acromegaly remains a safe and effective modality assuming careful attention is paid to technique, total dose, and fraction size." 07/01/2014 - "Transsphenoidal surgery for acromegaly: predicting remission with early postoperative growth hormone assays."
5.	lanreotide (Somatuline)FDA Link 09/01/2014 - "Lanreotide ATG provided hormonal control and improved both health-related quality of life and acromegaly symptoms in most patients; it also reduced tumour volume to a clinically significant extent in studies of primary therapy. " 01/01/2008 - "Subcutaneous lanreotide ATG was an effective and generally well tolerated treatment in patients with acromegaly in well designed trials and extension studies of up to 4 years' duration. " 01/01/2008 - "Subcutaneous lanreotide ATG was an effective and generally well tolerated treatment in patients with acromegaly in well designed trials and extension studies of up to 4 years duration. " 02/01/2006 - "This 3-year study shows that lanreotide Autogel is effective in controlling GH/IGF-1 hypersecretion and is well tolerated during long-term treatment of patients with acromegaly." 01/01/2009 - "Lanreotide is an effective treatment for active acromegaly. "
6.	Glucose (Dextrose)FDA LinkGeneric 08/01/2001 - "In some patients with active acromegaly, glucose-suppressed GH levels as measured by highly sensitive assay are much lower than could previously be appreciated with less sensitive GH assays and some other patients in apparent remission have subtle abnormalities of GH suppression. " 04/01/2004 - "A basal or random GH level of <2.5 microg/l is not a reliable criterion for remission in acromegaly and the currently accepted normal upper limit of 1 microg/l for post-glucose GH suppression is too high. " 10/01/1997 - "Glucose tolerance was improved after successful treatment of acromegaly." 01/01/2011 - "The cutoff value of nadir GH after an oral glucose tolerance test (OGTT) used to define disease remission in acromegaly is higher than that observed in healthy subjects. " 01/01/2008 - "Nadir GH during oral glucose tolerance test (OGTT) is the gold-standard test of GH secretion in treated acromegaly. "
7.	pegvisomant FDA LinkGeneric 01/01/2007 - "The GH receptor antagonist pegvisomant is a highly effective new treatment option in acromegaly. " 07/01/2001 - "Pegvisomant is a GH receptor antagonist and highly efficacious new treatment for acromegaly. " 01/01/2007 - "The GPOS database provides important information about treatment modalities, safety and efficacy of pegvisomant in patients with acromegaly." 07/01/2001 - "This is further evidence of the efficacy of pegvisomant in the management of acromegaly and has important implications for determining optimum glucocorticoid replacement." 01/13/2001 - "In a short term study (3 months) pegvisomant was shown to be an effective treatment for acromegaly. "
8.	Insulin (Novolin)FDA Link 07/01/2011 - "Control of acromegaly with either TSS or SSA improved insulin sensitivity as evident by significantly lower fasting and postglucose insulin levels and HOMA-IR. " 12/01/2015 - "Active acromegaly presents a unique combination of features associated with CV risk, reduced insulin sensitivity yet lower body fat and lower levels of some serum CV risk markers, a pattern that is reversed in remission. " 12/01/2015 - "Active acromegaly is associated with lower insulin sensitivity, body fat and CRP levels than acromegaly in remission. " 11/01/1995 - "These changes in LPL may be due to improved insulin sensitivity, or to other changes associated with acromegaly treatment." 09/01/2015 - "The aim of the study was to compare the central corneal thickness (CCT), intraocular pressure (IOP), and tear insulin-like growth factor-1 (IGF-1) levels of 2 patients with acromegaly before and after the surgical treatment of the disease. "
9.	Bromocriptine (Parlodel)FDA LinkGeneric 01/01/1978 - "Bromocriptine offers a major advance in the management of acromegaly, but further careful follow-up is required to determine whether serious side effects will be a problem with the long term use of high doses." 06/15/1989 - "It is effective in some cases of acromegaly, but has little to offer to those resistant to bromocriptine." 02/28/1981 - "4. Bromocriptine is effective and useful in the treatment of acromegaly. " 05/01/1984 - "In most studies reporting favourable results of chronic bromocriptine treatment in acromegaly, plasma GH levels are measured at fixed intervals during the day. " 08/01/1983 - "The present study does not not lend support to the idea that there is a fundamental difference in the degree of hypothalamic dopaminergic control of GH or Prl secretion between bromocriptine sensitive and bromocriptine insensitive patients with acromegaly."
10.	pasireotideIBA 04/01/2014 - "A 16-week, Phase II trial showed that pasireotide may be an effective treatment for acromegaly. " 06/01/2010 - "Pasireotide is a promising treatment for acromegaly. " 01/01/2013 - ", long-term safety and efficacy of pasireotide in patients with acromegaly and/or Cushing's disease are not fully clear." 11/01/2014 - "This randomized, open-label, Phase I study evaluated the safety, PK, and PD of pasireotide LAR 20, 40, or 60 mg/month in patients with acromegaly. " 11/01/2014 - "Pharmacokinetics, pharmacodynamics, and safety of pasireotide LAR in patients with acromegaly: a randomized, multicenter, open-label, phase I study."

Therapies and Procedures

1.	Radiotherapy 10/01/2010 - "Therefore, medical therapy to control excess GH secretion plays a significant role in a large proportion of patients with acromegaly who are not cured by surgery or other forms of therapy, such as radiotherapy, and/or are awaiting the effects of radiotherapy. " 08/01/2009 - "Radiosurgery for acromegaly results in a higher likelihood of remission and an earlier time to remission than does conventional radiotherapy. " 06/01/1998 - "The authors tested the assumption that gamma knife radiosurgery is more effective than fractionated radiotherapy for the treatment of patients with acromegaly who have undergone unsuccessful resective surgery. " 12/01/2015 - "This review article will discuss the biochemical assessments used for therapeutic monitoring in acromegaly, the importance of monitoring after surgery and medical therapy or radiotherapy, the consequences of suboptimal monitoring, and the need for improved monitoring algorithms for patients with acromegaly. " 12/01/2006 - "Acromegaly that has not been cured by microsurgery is usually treated with fractionated radiotherapy; however, it is not possible to repeat such a treatment with effective radiation doses if it should fail. "
2.	Aftercare (After-Treatment) 12/01/2008 - "Cardiac manifestations of GH deficiency after treatment for acromegaly: a comparison to patients with biochemical remission and controls." 01/01/2005 - "Normal or increased BMD was observed at the femoral neck and lumbar spine in both men and women in remission after treatment for acromegaly. " 11/01/2004 - "In conclusion, patients cured after treatment for acromegaly have a persistently decreased quality of life despite long-term biochemical cure of GH excess. " 11/01/1990 - "The value of serial measurements of heel pad thickness as a clinical predictor of biochemical remission in acromegaly was assessed in 25 patients followed for up to 20 years after treatment by interstitial irradiation using yttrium-90 implantation. " 12/01/2011 - "The aim of this study was to determine the frequency and characteristics of severe GH deficiency (sGHD) in patients after treatment of acromegaly by surgery alone. "
3.	Pituitary Irradiation 01/01/2011 - "A review of the recent literature suggests that pituitary irradiation is an effective treatment for acromegaly. " 01/01/1985 - "We confirm that external pituitary irradiation is effective in reducing elevated serum GH levels in acromegaly, but suggest that such a slow reduction in serum GH levels does not retard the development of cardiovascular complications." 06/18/1970 - "Efficacy of conventional pituitary irradiation in acromegaly." 01/01/2012 - "The 60-year-old male patient presenting with typical clinical signs of acromegaly has underwent multiple transsphenoidal surgeries and pituitary irradiation, while currently available pharmacological therapies for acromegaly have been exhausted. " 10/01/2009 - "It is established that external pituitary irradiation (EPI) effectively reduces serum GH levels in acromegaly. "
4.	Drug Therapy (Chemotherapy) 12/01/2015 - "Because acromegaly-related costs were driven by hospitalizations and pharmacotherapy, improved management of the disease may reduce the clinical and economic burden experienced by patients with acromegaly." 02/01/2009 - "Control of acromegaly by surgery or pharmacotherapy has been shown to improve cardiovascular morbidity. " 12/01/2015 - "Assessed outcomes included prevalence of acromegaly diagnosis and incidence of new acromegaly diagnoses during the study period (January 1, 2008-July 31, 2013), acromegaly-related comorbidities, and pharmacotherapy use. " 02/01/2015 - "[Acromegaly and pharmacotherapy]." 06/01/2014 - "Advances in the pharmacotherapy of patients with acromegaly."
5.	Injections 07/01/2000 - "We developed the Impact on Lifestyle Questionnaire (ILQ) to measure the impact on patient's lifestyle imposed by the burden of injectable treatments for acromegaly. " 08/01/1987 - "Eight patients with acromegaly, two of whom had elevated basal levels of PRL, were also tested with single bolus injections. " 12/01/2001 - "Patients with acromegaly, who are not cured after transsphenoidal adenomectomy, may be treated with external irradiation and/or octreotide injections. " 09/01/1987 - "In seven patients with active acromegaly we compared, in a short-term trial, the effect of SMS 201-995 administered by continuous sc infusion (50 micrograms and 100 micrograms a day) and by three sc injections (100 micrograms each). " 10/01/2013 - "The purpose of this article was to demonstrate that an octreotide implant (84 mg) is safe and efficacious in patients with acromegaly who were responsive to prior monthly octreotide long-acting release (LAR) injections. "