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A practical approach to acromegaly management in Latin America
Authors:Bronstein  Marcello D  Bruno  Oscar D  Abreu  Alin  Mangupli  Ruth  Mercado  Mois&#;s
Institution:1.Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho, 255, 7ºandar, sala 7037, São Paulo, CEP 05403-000, Brazil
;2.Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
;3.Endocrinología, Centro Médico Imbanaco Cali, Cali, Colombia
;4.Section of Neuroendocrinology, Department of Neurosurgery, Hospital Universitario, Caracas, Venezuela
;5.Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
;6.Head Endocrine Service, and Experimental Endocrinology Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Segero Social, Mexico City, Mexico
;
Abstract:Introduction

Evidence-based treatment guidelines have undoubtedly advanced medical practice and supported optimal management of acromegaly, but their application may be hampered by limited access to the latest treatment options.

Methods

In this retrospective, narrative review, the authors revisited existing treatment guidelines for acromegaly in Latin America. These were considered in conjunction with published evidence chosen at the authors’ discretion.

Findings

In a socially and economically diverse region, such as Latin America, any regional practice guidelines need to appreciate that recommended treatment options, such as surgery by expert pituitary surgical teams and drug therapies, especially somatostatin analogs, are often not available due to limited resources. In these instances, physicians may be obliged to apply less effective therapeutic options.

Conclusions

The current article looks at the practical aspects of acromegaly management in Latin America and discusses this in the context of existing guidelines. Furthermore, we consider potential strategies to make better use of resources through combination and multimodal approaches to treatment.

Keywords:
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