Abstract
Context Acromegaly is a rare disease caused by excessive growth hormone
(GH) secretion from pituitary adenomas in most cases. If neurosurgical therapy
is contraindicated or not sufficient, medical therapy is the second line
therapy.
Objective To describe current medical therapy in acromegaly.
Design & Methods Retrospective data analysis from 2732 patients
treated in 69 centers of the German Acromegaly Registry. 749 patients were seen
within the recent 18 months, of which 420 were on medical therapy
(56.1%).
Results 73% of medically treated acromegalic patients had
normal/low IGF-1 levels. 57% of patients with non-normalized
IGF-1 levels had an IGF-1 value between 1- and 1.25-fold above the upper limit
of normal. Most patients (55%) received somatostatin analogs as
monotherapy, 12% GH receptor monotherapy, and 9% dopamine
agonist therapy. Doses of each medical therapy varied widely, with 120 mg
lanreotide LAR every 4 weeks, 30 mg octreotide LAR every 4 weeks, 140 mg
pegvisomant per week and 1mg cabergoline per week being the most frequent used
regimens. A combination of different medical regimens was used in almost
25% of the patients.
Conclusion The majority of German acromegalic patients receiving medical
therapy are controlled according to normal IGF-1 levels.
Key words
Acromegaly - growth hormone - IGF-1 - cabergoline - lanreotide - octreotide - pegvisomant
