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MANAGEMENT OF ENDOCRINE DISEASE: Individualized Management of Acromegaly.

08:00 EDT 1st May 2019 | BioPortfolio

Summary of "MANAGEMENT OF ENDOCRINE DISEASE: Individualized Management of Acromegaly."

Acromegaly is a rare and challenging disease calling for management in highly specialized multidisciplinary teams (MDTs). Untreated disease has severe morbidity and a clearly increased mortality. Major attainments have been gained over the latest decades, and therefore the aim of this review is to discuss recent achievements in modern multimodal therapy of acromegaly performed by MDTs, with an emphasis on an individualized, proactive management from the time of diagnosis to long term outcome. Treatment by surgery is the only potential curative treatment, however even with modern techniques still with modest cure rates, leaving the patients to often long-term medical treatment. Treatment strategies have changed dramatically in the Western world over recent years, implying a more proactive treatment algorithm often with a shorter or longer pre-surgical treatment period with Somatostatin Receptor Ligands (SRLs). Not all patients will however respond to primary treatment with conventional SRLs and there has recently been a development of potential biomarkers for response that has been implemented in the clinical routine. By today, multimodal treatment can bring every patient in remission, but still almost a third of all patients are undertreated according to large, international registries. On the other hand, it might be a challenge not to over-treat thereby bringing the patient into a state of relative or absolute growth hormone deficiency. Clinical series published during the last decade on treatment of patients with acromegaly have indicated a normalization of mortality, most probably reflecting the proactive and individualized modern treatment. In conclusion, modern, multimodal treatment seems to have normalized mortality, but still the patients suffer from a high multi-organ morbidity and often multi-pharmacy. Every patient should receive an individualized, pro-active treatment in order to improve long-term outcome and to reduce costs for the society.

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Name: European journal of endocrinology
ISSN: 1479-683X
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