Current therapies and mortality in acromegaly

Area of Science:

• Endocrinology
• Oncology
• Neurosurgery

Background:

• Acromegaly, often caused by pituitary adenomas, reduces lifespan by approximately ten years without treatment.
• Pituitary surgery is the primary treatment for GH-secreting adenomas, with significantly lower mortality in operated patients.

Purpose of the Study:

• To review the impact of various acromegaly therapies on patient mortality.
• To highlight the effectiveness of modern medical and surgical approaches in managing acromegaly.

Main Methods:

• Analysis of existing meta-analyses and studies on acromegaly treatment outcomes.
• Comparison of mortality rates across different therapeutic strategies, including surgery, somatostatin receptor analogues (SRAs), dopamine agonists (DAs), and radiotherapy.

Main Results:

• Surgical intervention lowers mortality, normalizing it with controlled GH levels (<1 μg/L).
• Somatostatin receptor analogues (SRAs) are associated with reduced mortality when utilized >30% of the time.
• Conventional radiotherapy is linked to increased mortality, primarily from cerebrovascular diseases.

Conclusions:

• Modern therapies, including monotherapy or multimodal approaches in experienced centers, can reduce acromegaly-related mortality to general population levels.