Evidence comparing different medications for acromegaly is limited. However, a recent network meta-analysis provides strong evidence that supports the treatment strategy outlined in Acromegaly: An Endocrine Society Clinical Practice Guideline of the US Endocrine Society. Those guidelines address important clinical issues regarding the evaluation and management of acromegaly.
Recommendations include:
For most patients with acromegaly, surgical removal of the pituitary gland tumor should be considered the primary treatment.
An imaging study should be performed at least 12 weeks post-surgery to determine whether any residual tumor tissue is present.
Patients should be evaluated for any damage caused by the pituitary tumor and for the development of hypopituitarism.
Medical therapy should be administered only to patients with persistent postoperative disease.
In general, radiation therapy is recommended if GH hypersecretion is not normalized with surgery. Radiation treatment takes years to reduce/normalize GH/IGF-I levels.
Somatostatin and dopamine analogues and GH receptor antagonists are the mainstays of medical treatment for GH excess and are generally used when primary surgery fails to induce complete remission.
Learn more about the treatment of acromegaly.
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Cite this: Romesh Khardori. Fast Five Quiz: Test Your Knowledge of Acromegaly - Medscape - Sep 16, 2020.
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