Guideline Developed for Management of Acromegaly
Therapeutic algorithm includes surgery for most patients, adjuvant medical therapy, radiotherapy
MONDAY, Nov. 10, 2014 (HealthDay News) -- Recommendations have been developed for the diagnosis and management of acromegaly. The new clinical practice guideline was published in the November issue of the Journal of Clinical Endocrinology & Metabolism.
Laurence Katznelson, M.D., from Stanford University School of Medicine in California, and colleagues developed an evidence-based clinical practice guideline for acromegaly. Primary evidence was reviewed and two additional systematic reviews were commissioned.
The guideline addresses issues regarding the evaluation and management of acromegaly, including appropriate biochemical assessment followed by an imaging study. The therapeutic algorithm should include transsphenoidal surgery as the primary therapy for most patients. Medical therapy is recommended in patients with persistent disease following surgery, and should include either a somatostatin receptor ligand or pegvisomant as the initial adjuvant therapy for patients with significant disease, or a dopamine agonist. Radiation therapy is suggested if medical therapy is unavailable, unsuccessful, or not tolerated, and stereotactic radiotherapy is recommended over conventional radiation therapy. Specific recommendations are provided for managing acromegaly during pregnancy.
"Overabundance of growth hormone and insulin-like growth factor-1 can reduce life span and lower quality of life for people with acromegaly, so it is crucial to identify a treatment plan to control hormone levels and the tumor itself," Katznelson said in a statement. "The condition often requires individualized treatment because signs and symptoms can vary from patient to patient."
Several authors disclosed financial ties to the pharmaceutical industry.