Endocrine Abstracts

Objective

In order to improve therapeutic outcomes for patients with acromegaly, new treatment algorithms have been developed over the last decades. Valid epidemiological data of acromegaly in Norway is lacking. The overall aim of this study was to investigate incidence, prevalence and mortality of acromegaly in South-Eastern Norway, and to investigate effects of new treatment algorithms.

Design and method

Patients with acromegaly from South-Eastern Health region of Norway (56% of the total Norwegian population) diagnosed between 1999–2019 were included in a register-based cohort (n = 262). For every patient 100 age and sex matched controls from the general population were obtained (n = 26200) and combined with individual data from the national cause of death registry. Mortality was assessed by Kaplan-Meier analysis, cox regression and hazard ratios (HRs).

Results

Mean age at diagnosis was 48.7 years (CI: 95%: 45.9–49.4) and did not differ between men and women (P = 0.811). The mean annual incidence rate was 4.7 (95% CI: 4.2–5.3) cases/10⁶ persons and the point prevalence in 2019 was 83 cases/106. During the study period, 14 acromegaly cases died, five from cancer, three from cardiovascular disease and six from other causes. Overall mortality risk was elevated (HR: 2.79 (95% CI: 1.64–4.75). For patients diagnosed in period 1999–2005 and 2006–2012 the HR for mortality was 2.86 (95% CI: 1.35–6.05), and 2.96 (95% CI: 1.31–6.66). For the patients diagnosed in 2013–2019 this was 1.87 (95% CI: 0.26–13.50)). IGF-1 levels at diagnosis did not clearly influence mortality (HR: 0.59 (95% CI: 0.31–1.14)).

Conclusion

In South-Eastern Norway, the mortality in patients with acromegaly is elevated compared to the general population and comparable to results from other population-based studies in the Nordic countries and Europe.