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2015 ; 8
(4
): 411-5
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Current therapies and mortality in acromegaly
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G?loiu S
; Poian? C
J Med Life
2015[Oct]; 8
(4
): 411-5
PMID26664461
show ga
Acromegaly is a rare disease most frequently due to a GH secreting pituitary
adenoma. Without an appropriate therapy, life of patients with acromegaly can be
shortened with ten years. Pituitary surgery is usually the first line therapy for
GH secreting pituitary adenomas. A meta-analysis proved that mortality is much
lower in operated patients, even uncured, than the entire group of patients and
is similar with the general population in patients with GH<1 ?g/ L. For the
patients with hypersecreting postoperative remnant tumor, those with low chance
of surgical cure or with life-threatening comorbidities, medical therapies are
available: somatostatin receptor analogues (SRA), dopamine agonists (DA) and GH
receptor antagonists. Studies with >30% utilization of SRAs reported a lower
mortality ratio than studies with lower percentages of SRA administration.
Although therapy with DA has long been used in patients with acromegaly, there
are no studies reporting its effect on mortality, but its efficacy is limited by
the low remission rate obtained. The use of conventional external radiotherapy,
although with good remission rate in time, was linked with increased mortality,
mostly due to cerebrovascular diseases. CONCLUSION: Mortality in acromegaly can
be reduced to expected levels from general population by using modern therapies
either in monotherapy or by using multimodal approaches in experienced centers.
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