Long-term outcomes of patients with acromegaly: a report from the Swedish Pituitary Register.
Eur J Endocrinol
; 186(3): 329-339, 2022 Feb 01.
Article
in En
| MEDLINE
| ID: mdl-35007208
ABSTRACT
OBJECTIVE:
To describe the treatment and long-term outcomes of patients with acromegaly from all healthcare regions in Sweden. DESIGN ANDMETHODS:
Analysis of prospectively reported data from the Swedish Pituitary Register of 698 patients (51% females) with acromegaly diagnosed from 1991 to 2011. The latest clinical follow-up date was December 2012, while mortality data were collected for 28.5 years until June 2019.RESULTS:
The annual incidence was 3.7/million; 71% of patients had a macroadenoma, 18% had visual field defects, and 25% had at least one pituitary hormone deficiency. Eighty-two percent had pituitary surgery, 10% radiotherapy, and 39% medical treatment. At the 5- and 10-year follow-ups, insulin-like growth factor 1 levels were within the reference range in 69 and 78% of patients, respectively. In linear regression, the proportion of patients with biochemical control including adjuvant therapy at 10 years follow-up increased over time by 1.23% per year. The standardized mortality ratio (SMR) (95% CI) for all patients was 1.29 (1.11-1.49). For patients with biochemical control at the latest follow-up, SMR was not increased, neither among patients diagnosed between 1991 and 2000, SMR 1.06 (0.85-1.33) nor between 2001 and2011, SMR 0.87 (0.61-1.24). In contrast, non-controlled patients at the latest follow-up from both decades had elevated SMR, 1.90 (1.33-2.72) and 1.98 (1.24-3.14), respectively.CONCLUSIONS:
The proportion of patients with biochemical control increased over time. Patients with biochemically controlled acromegaly have normal life expectancy, while non-controlled patients still have increased mortality. The high rate of macroadenomas and unchanged age at diagnosis illustrates the need for improvements in the management of patients with acromegaly.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vision Disorders
/
Acromegaly
/
Somatostatin
/
Adenoma
/
Antineoplastic Agents, Hormonal
/
Neurosurgical Procedures
/
Growth Hormone-Secreting Pituitary Adenoma
Type of study:
Etiology_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Eur J Endocrinol
Journal subject:
ENDOCRINOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Sweden