Acromegaly treatment in Romania. How close are we to disease control?

Endokrynol Pol. 2017;68(5):519-523. doi: 10.5603/EP.a2017.0041. Epub 2017 Sep 7.

Abstract

Introduction: In Romania, no nationwide data for acromegaly treatment and control rate are available. Our objective was to assess the acromegaly control rate in a tertiary referral centre, which covers an important part of Romanian territory and population of patients with acromegaly.

Materials and methods: We reviewed the records of all 164 patients (49 males and 115 females; median age 55 [47, 63.5] years) with newly or previously diagnosed acromegaly, who have been assessed at least once in our tertiary referral centre between January 1, 2012 and March 31, 2016. This sample represents 13.6% of the total expected 1200 Romanian patients with acromegaly and covers 82.9% of the counties in Romania. Control of acromegaly was defined as a random serum growth hormone (GH) < 1 ng/mL and an age-normalised serum insulin-like growth factor-I (IGF-I) value. The GH and IGF-I values used for calculation of the control rate were those at the last evaluation. The same assays for GH and IGF-I measurement were used in all patients.

Results: There were 147 treated and 17 untreated patients. Of the 147 patients assessed after therapy, 137 (93.2%) had pituitary surgery, 116 (78.9%) were on medical treatment at the last evaluation, and 67 (45.5%) had radiotherapy. Seventy-one (48.3%) had a random GH < 1 ng/mL, 54 (36.7%) had a normalised, age-adjusted IGF-I, and 42 (28.6%) had both normal random serum GH and IGF-I.

Conclusions: In Romania, acromegaly benefits from the whole spectrum of therapeutic interventions. However, the control rate remains disappointing.

Keywords: Romania; acromegaly; control rate; treatment.

MeSH terms

  • Acromegaly / blood
  • Acromegaly / drug therapy*
  • Acromegaly / radiotherapy
  • Acromegaly / surgery*
  • Disease Management*
  • Female
  • Human Growth Hormone / blood
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Middle Aged
  • Pituitary Gland / drug effects
  • Pituitary Gland / surgery*
  • Radiotherapy
  • Romania

Substances

  • Human Growth Hormone
  • Insulin-Like Growth Factor I