Acromegaly management and outcomes: a 47-year single-centre experience

Trevor Tam; Thazin Wynn; Emma Miler; Allison Chipchase; Francesca Swords; Ketan Dhatariya; Rupa Ahluwalia

doi:10.1530/endoabs.117.P189

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Endocrine Abstracts (2026) 117 P189 | DOI: 10.1530/endoabs.117.P189

SFEBES2026 Poster Presentations Neuroendocrinology and Pituitary (40 abstracts)

Acromegaly management and outcomes: a 47-year single-centre experience

Trevor Tam ^1,2 , Thazin Wynn ¹ , Emma Miler ¹ , Allison Chipchase ¹ , Francesca Swords ¹ , Ketan Dhatariya ^1,2 & Rupa Ahluwalia ¹

Author affiliations

¹Norfolk and Norwich University Hospital, Norwich, United Kingdom; ²University of East Anglia, Norwich, United Kingdom

Background: Acromegaly is usually caused by a pituitary adenoma, resulting in excess growth hormone (GH) with high insulin-like growth factor-1 (IGF-1) levels. Neurosurgical, radiotherapy, and pharmacological treatment options have advanced. We evaluated outcomes of 71 patients over 47 years.

Methods: Retrospective review of all diagnosed with acromegaly between 1978–2025. Data were obtained from electronic and paper records. Biochemical remission was defined as nadir GH <1 µg/l and normal age-adjusted IGF-1.

Results: 71 patients (59.2% males) included (mean age 58.6 ± 1.8 years). Macroadenomas present in 44/71 (62%); microadenomas in 22/71 (31%); remaining 5/71 (7%) with unknown tumour size. Dopamine agonists (DA) were prescribed in 25/71 (35.2%); somatostatin analogues (SSA) in 21/71 (29.6%); Pegvisomant in 3/71 (4.2%); 6 achieved remission with medical therapy alone. 51 patients achieved biochemical remission (table 1); 34/51 (66.7%) required multimodal treatment. 9/58 (15.5%) required GH replacement post-operatively. Discordance between GH and IGF-1 results occurred in 38/71 (53.5%) patients.

Table 1: treatment outcomes
Treatment Modality	Number of patients	Number of macro-adenomas	Number of micro-adenomas	Biochemical remission or control
Surgery alone	11	6	5	10
Surgery + radiotherapy	6	3	2	7
Surgery + medical therapy	12	8	3	6
Surgery + radiotherapy + medical therapy	29	19	7	20
Radiotherapy + medical therapy	1	1	0	1
Medical therapy alone	10	5	5	6
No therapy necessary (pituitary apoplexy)	1	1	0	1
Insufficient data	1	1	0	0
Total	71	44	22	51

Conclusion: Across over four decades of practice, 51/71 (71.8%) of patients achieved biochemical remission or control. Persistent discordance occurred in 53.5% patients, contributing to ongoing challenges in monitoring and defining cure.