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Medical therapy in acromegaly.

Mark Sherlock1, Conor Woods, Michael C Sheppard

  • 1Centre for Endocrinology Diabetes and Metabolism, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.

Nature Reviews. Endocrinology
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PubMed
Summary

Acromegaly, a rare disease of excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1), can be managed with therapies to normalize levels. Treatment options include surgery, radiotherapy, and various medical therapies to reduce morbidity and mortality.

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Area of Science:

  • Endocrinology
  • Rare Diseases
  • Pharmacology

Background:

  • Acromegaly results from excessive growth hormone (GH) and insulin-like growth factor 1 (IGF-1) secretion.
  • This condition leads to significant morbidity and premature mortality.
  • Effective management requires normalization of GH and IGF-1 levels.

Purpose of the Study:

  • To provide an overview of current and future pharmacological therapies for acromegaly.
  • To discuss treatment strategies aimed at reducing GH and IGF-1 levels.
  • To explore therapeutic options for managing acromegaly symptoms and pituitary adenoma effects.

Main Methods:

  • Review of existing literature on acromegaly treatments.
  • Analysis of pharmacological options including dopamine agonists, somatostatin receptor ligands, and pegvisomant.
  • Discussion of medical therapy as primary and secondary treatment.

Main Results:

  • Therapeutic goals include decreasing GH and IGF-1 levels to <2.5 μg/l and normalizing IGF-1.
  • Available treatments encompass surgery, radiotherapy, and medical therapies.
  • Medical therapy is increasingly utilized as a primary treatment option.

Conclusions:

  • Pharmacological interventions are crucial for managing acromegaly.
  • Current medical therapies offer effective options for persistent or recurrent disease.
  • Future research will likely focus on advancing medical treatments for acromegaly.