Published in:
Open Access
01-01-2014
Multiple facets in the control of acromegaly
Authors:
Lucio Vilar, Alex Valenzuela, Antônio Ribeiro-Oliveira Jr., Claudia M. Gómez Giraldo, Doly Pantoja, Marcello D. Bronstein
Published in:
Pituitary
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Special Issue 1/2014
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Abstract
Aims
The current article provides a brief overview of the criteria for defining disease control in acromegaly.
Methods
This was a retrospective, narrative review of previously published evidence chosen at the author’s discretion along with an illustrative case study from Latin America.
Findings and Conclusions
In the strictest sense, “cure” in acromegaly is defined as complete restoration of normal pulsatile growth hormone secretion, although this is rarely achieved. Rather than “cure”, as such, it is more appropriate to refer to disease control and remission, which is defined mainly in terms of specific biochemical targets (for growth hormone and insulin-like growth factor-1) that predict or correlate with symptoms, comorbidities and mortality. However, optimal management of acromegaly goes beyond biochemical control to include control of tumour growth (which may be independent of biochemical control) and comprehensive management of the symptoms and comorbidities typically associated with the disease, as these may not be adequately managed with acromegaly-specific therapy alone.