Multiple facets in the control of acromegaly |
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Authors: | Vilar Lucio Valenzuela Alex Ribeiro-Oliveira Antnio Gmez Giraldo Claudia M Pantoja Doly Bronstein Marcello D |
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Institution: | 1.Division of Endocrinology and Metabolism, Hospital das Clinicas, Federal University Medical School, Recife, Pernambuco, Brazil ;2.Department of Internal Medicine, Fundación Cardio-Infantil, Instituto de Cardiología, Universidad del Rosario, Bogotá, Colombia ;3.Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil ;4.Hospital Universitario de San Ignacio and Organización Colsánitas Internacional, Bogotá, Colombia ;5.Universidad de Nariño, Pasto, Colombia ;6.Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho, 255, 7ºandar, sala 7037, São Paulo, CEP 05403-000, Brazil ; |
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Abstract: | Aims The current article provides a brief overview of the criteria for defining disease control in acromegaly. MethodsThis was a retrospective, narrative review of previously published evidence chosen at the author’s discretion along with an illustrative case study from Latin America. Findings and ConclusionsIn the strictest sense, “cure” in acromegaly is defined as complete restoration of normal pulsatile growth hormone secretion, although this is rarely achieved. Rather than “cure”, as such, it is more appropriate to refer to disease control and remission, which is defined mainly in terms of specific biochemical targets (for growth hormone and insulin-like growth factor-1) that predict or correlate with symptoms, comorbidities and mortality. However, optimal management of acromegaly goes beyond biochemical control to include control of tumour growth (which may be independent of biochemical control) and comprehensive management of the symptoms and comorbidities typically associated with the disease, as these may not be adequately managed with acromegaly-specific therapy alone. |
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