Q J Med 2000; 93: 1-6
© 2000 Association of Physicians
Editorial |
Modern approaches to treating acromegaly
Department of Endocrinology, Radcliffe Infirmary, Oxford
Only a couple of months ago in the Times, acromegaly was described as a serious disease causing grotesque appearances and crippling arthritis.1 The aim of this article is to discuss the recent advances and developments in management of acromegaly that make the likelihood of this situation developing vanishingly small.
Acromegaly leads to reduced life-expectancy, with a 2–3-fold increase in mortality. However, patients with post-treatment growth hormone (GH) of <5 mU/l have been shown to have the same mortality as the general population2–4 and recently, normalization of IGF-1 has also been shown to reduce mortality to that of the general population.5 Therefore the main aims of management of patients with acromegaly are to control the tumour and its effects, and to reduce GH and IGF-1 levels. There have been many recent developments, in currently accepted modalities of treatment as well as novel approaches to therapy.
Trans-sphenoidal adenomectomy remains the initial
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