Endocrine Abstracts (2017) 49 EP1047 | DOI: 10.1530/endoabs.49.EP1047

Considerable delays to achieve adequate control in treating patients with acromegaly

Marinella Tzanela, Olga Karapanou, Christianna Giatra, Efstathia Botoula, Elisabeth Tiaka, Lambraki Anastasia & Stylianos Tsagarakis

Department of Endocrinology and Diabetes, Evangelismos Hospital, Athens, Greece.

Acromegaly is a rare disease that leads to considerable morbidity and mortality, both reversible by adequate control of the disease. However, patients that could be adequately controlled confront delays in achieving treatment targets. The aim of the present study was to estimate the time to disease control after diagnosis and the reason leading to control delays. We retrospectively studied 119 acromegalic patients (aged 46.4±12.5; 71 females). Following appropriate treatment modalities all achieved IGF-1 levels within normal limits for age (43 pts had GH <1.0 ng/ml, and 76 pts had GH <2.5 ng/ml). Acromegaly was adequately controlled within 0-6 months in 19 patients (15.9%), within 6–12 in 14 (11.8%), and within 12–24 in 21 (17.6%). In 65 patients (54.6%) disease control was achieved after 24 months (25–412, median 103 months). Earlier controlled patients were older (50±11.9 vs 43.5±12.3, P=0.00434), and underwent surgery sooner after the diagnosis (8.0±6.8 vs 19.8±30.9 months P=0.0324). When under medical treatment, the main reasons for delay control were the late referral and initiation of medical therapy (5.4±5.0 vs 124.6±117.1 months, P=0.0138), and the time elapsed to modify dosage and/or implementing alternative treatment options (4.4±3.7 vs 16.1±11.1 months, P=0.0138). Tumor size or extension, GH and IGF-1 had no impact to time to control. According to our audit a substantial proportion of patients remain uncontrolled for several months despite the efficacy of available therapeutic modalities in these patients. The main reason seems to be the delay to cease early surgical intervention or to adjust the medical treatment options.

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