Aims: The diagnosis and treatment of acromegaly have undergone various refinements over
time due a combination of increased understanding of the pathophysiology of the disease
and the introduction of new techniques and therapies. Information on the characteristics
of acromegalic patients is traditionally derived from clinical trials; data generated
from experience in the setting of everyday management at large clinical centers remains
relatively scant.
Methods: Using a proprietary electronic database developed by Graphmed Ltd., we evaluated
the demographic, clinical, hormonal/biochemical and radiological characteristics of
acromegalic patients treated from 1952–2005 in the Departments of Endocrinology and
Neurosurgery of the CHU de Liège and ancillary hospital facilities. Pre-designated
data on individual patients were retrieved from case files, radiological images, surgical
notes and pathology reports; these data were entered into the Liège Acromegaly Survey
database and underwent statistical analysis.
Results: The Survey database included 197 acromegalic patients (101M/96F) as of 10/2005. The
mean age at diagnosis was 44.1±13.6 years (range 12–72 years); the duration of diagnosed
acromegaly ranged from 1–30 years. Patients were classified as sporadic (188), familial
(5), McCune-Albright syndrome (2) or MEN-1 (2). In patients with valid radiological
data, 78% had macroadenomas. Mean GH and IGF-I levels at diagnosis were higher in
younger (<30yr) versus older patients (>65yr). Hormonal control was achieved in 78%
of patients overall. Post-treatment hypopituitarism occurred in 35 (17.8%) patients:
1 axis (11), 2 axes (6), 3 axes (15), complete (3).
Conclusion: Organized assessment of the characteristics and response to therapy of patients with
acromegaly treated in the clinical setting can help to confirm the findings of clinical
trials. GH and IGF-I at diagnosis was higher at young patients than in older patients
and hormonal control was achieved in 78% of patients overall. The prevalence of hypopituitarism
post-therapy was low in this series.
