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  • Title: [Therapeutic management of acromegaly].
    Author: Metzner C, Hadziselimovic S, Grafe I, Nawroth P, Kasperk C.
    Journal: Med Klin (Munich); 2006 Jan 15; 101(1):15-23. PubMed ID: 16418810.
    Abstract:
    BACKGROUND: Only 60% of the patients with acromegaly are biochemically cured (growth hormone [GH] nadir < 1.0 microg/l after an oral glucose load, normalized age- and gender-matched insulin-like growth factor-1 [IGF-1] levels) after transsphenoidal surgery of the pituitary gland. In the absence of a remission there are effective pharmacological treatment regimens available which are able to lower GH and IGF-1 serum levels. THERAPEUTIC STRATEGIES: Somatostatin analogs, a GH receptor antagonist and dopamine agonists have been shown to alleviate the comorbid features and to normalize GH and IGF-1 levels. CASE REPORTS: In this overview six case reports are presented to highlight the current pharmacological treatment options and to propose an algorithm for the clinical routine in patients with persisting acromegaly. CONCLUSION: Transsphenoidal surgery is the treatment of choice for the initial management of acromegaly. In the absence of a remission there are effective pharmacological treatment regimens available among which somatostatin analogs are recommended as the first-line treatment.
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