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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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International Multicenter Validation Study of the SAGIT® Instrument in Acromegaly.

Andrea Giustina1, Marcello D Bronstein2, Philippe Chanson3

  • 1Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, 20132, Milan, Italy.

The Journal of Clinical Endocrinology and Metabolism
|July 27, 2021
PubMed
Summary

The SAGIT instrument accurately assesses acromegaly activity by evaluating signs, symptoms, comorbidities, hormone levels, and tumor features. This tool helps differentiate between controlled and non-controlled disease, aiding treatment decisions.

Keywords:
SAGIT® instrumentacromegaly controlacromegaly managementclinician-reported outcomes

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Area of Science:

  • Endocrinology
  • Clinical Diagnostics

Background:

  • Acromegaly disease activity requires accurate characterization for effective management.
  • The SAGIT instrument was developed to address this need for precise disease assessment.

Purpose of the Study:

  • To evaluate the SAGIT instrument's ability to discriminate between controlled and non-controlled acromegaly.
  • To identify key SAGIT components that best predict disease control status.

Main Methods:

  • A multicenter, longitudinal study involving 227 adult patients with controlled or non-controlled acromegaly.
  • Classification and Regression Tree (CART) analyses were used to assess SAGIT components (Signs/Symptoms, Associated comorbidities, Growth hormone levels, Insulin-like growth factor 1 levels, Tumor features) at baseline.
  • Disease control was assessed using the Clinical Global Evaluation of Disease Control (CGE-DC) questionnaire, clinician judgment, and international guidelines over a 2-year follow-up.

Main Results:

  • Lower mean SAGIT subscores for S, G, I, and T were observed in patients with CGE-DC controlled acromegaly compared to non-controlled.
  • CART analysis identified specific SAGIT components (I & G for CGE-DC; S, A, G, I, T for clinician decision; I for guidelines) as discriminators of disease control.
  • Patients with non-controlled acromegaly had a 3.44 times greater risk of requiring treatment changes.

Conclusions:

  • The SAGIT instrument is a validated and sensitive tool for comprehensive and accurate assessment of acromegaly severity.
  • SAGIT aids in differentiating disease control status, supporting clinical decision-making and patient management.