Acromegaly: Frequently Asked Questions
What is acromegaly?
Acromegaly is a rare chronic disorder caused by the presence of a pituitary adenoma, which results in the hypersecretion of growth hormone (GH) and subsequent elevation of circulating and locally produced insulin-like growth factor-1 levels (IGF-1). The clinical presentation of acromegaly is characterized by skeletal overgrowth deformities, particularly of the hands, feet and face, cardiovascular disease, neuropathy and respiratory obstruction. ...
Source: www.sandostatin.com
Acromegaly is a disease that occurs when the body makes too much growth hormone.
Source: www.somavert.com
Is Acromegaly a fatal disease?
Acromegaly itself is usually not fatal but the complications of Acromegaly can be life threatening. Successful treatment of Acromegaly will usually restore normal health.
Source: medindia.org
How can Acromegaly be prevented?
There is no known way to prevent Acromegaly. Early detection is the best way to prevent severe symptoms and complications.
Source: medindia.org
What medications are available for treatment of Acromegaly?
Currently used drugs include: Dopamine agonist: bromocriptine (Parlodel), cabergoline (Dostinex), pergolide (Permax)
Somatostatin analogs: octreotide (Sandostatin), octreotide LAR (Sandostatin LAR), lanreotide or lanreotide (Autogel; not currently available in the U.S.). Growth hormone receptor antagonist, pegvisomant (Somavert).
Source: www.pituitarysociety.org
Currently used drugs include: Dopamine agonist: bromocriptine (Parlodel), cabergoline (Dostinex), pergolide (Permax) Somatostatin analogs: Sandostatin LAR, lanreotide (not available in the U.S.). Growth hormone receptor antagonist, pegvisomant (Somavert).
Source: www.healthsystem.virginia.edu
What is first-line therapy for acromegaly?
Transsphenoidal surgical excision of the pituitary adenoma is usually first-line therapy in acromegaly. The procedure is associated with normalization of GH levels in approximately 90% of patients with well-defined microadenomas. 8-11 Surgical remission rates are lower in patients with macroadenomas because of the large, fibrous, and frequently invasive nature of these tumours, which makes complete resection unlikely. ...
Source: www.sandostatin.com
What are the goals of treatment for acromegaly?
The goals of treatment in acromegaly include normalization of GH and IGF-1 levels, reduction in tumour size, prevention of tumour recurrence, and alleviation of significant comorbid features, particularly cardiovascular, pulmonary and metastatic derrangements. 4,5 There has been considerable debate on the appropriate level of GH to be achieved when treating acromegaly. ...
Source: www.sandostatin.com
When is it appropriate to treat acromegaly with Sandostatin®?
Sandostatin ® is typically used as second-line treatment in patients whose GH levels remain elevated after surgery, or in those patients for whom surgical resection is not an option. 5 Based on the results of independent investigations, it has been proposed that it should also be considered as first-line treatment in patients with acromegaly caused by a macroadenoma, in whom the chances of surgical cure are reduced. ...
Source: www.sandostatin.com
What problems can acromegaly cause?
You may notice: Growth or swelling in hands or feet or an increase in ring or shoe size
Growth in facial features (like the chin, forehead, or nose)
Increased spacing of teeth
Enlarged tongue
Increased sweating, unpleasant odor
A tired feeling most of the time You may also have: Headache
Vision problems
Thick, oily skin
Pain in the joints (like the knees or hips)
Weak muscles
Tingling (pins-and-needles feeling), numbness (abnormal feeling), or weakness of the hands
Missing or irregular periods
Unusual tiredness or exhau... ...
Source: www.somavert.com
What are the recommendations for dosage and administration of Sandostatin® LAR® in patients with acromegaly?
Patients currently receiving subcutaneous Sandostatin ® can be switched to a 20-mg intramuscular dose of Sandostatin ® LAR ® given every 4 weeks. 21 After 3 months' therapy, the dose of Sandostatin ® LAR ® can be decreased to 10 mg every 4 weeks or increased to a maximum of 30 mg every 4 weeks, according to response. Assessment of GH and IGF-1 levels should be performed every 6 months.
Source: www.sandostatin.com
What types of pharmacological therapy are suitable for acromegaly?
The type of pharmacological therapy recommended for acromegaly depends on a number of factors relating to the individual patient, the severity and complications of the disease, and the risk/benefit ratio of the particular treatment modality. 4 Long-acting somatostatin analogs, such as octreotide acetate (Sandostatin ® ), are the mainstay of pharmacological treatment. 5 Oral dopamine agonists, such as bromocriptine mesylate (Parlodel ® ), constitute another therapeutic option. ...
Source: www.sandostatin.com
What are the recommendations for dosage and administration of Sandostatin® in patients with acromegaly?
The recommended starting dose of Sandostatin ® in acromegaly is 150 µg/day, given subcutaneously in three 50 µg doses (t.i.d. ); however, the dose of Sandostatin ® used to treat acromegaly must be individualized for each patient and titrated for optimal response. 21 Indeed, a recent study found that men with acromegaly may require a higher dose of Sandostatin ® than women due to gender-specific differences in GH sensitivity; 22 however, no age-specific effects have been observed. ...
Source: www.sandostatin.com
How are patients with acromegaly refractory to surgical intervention managed?
For patients with acromegaly who are not candidates for surgery, or for whom surgery is unsuccessful, alternative approaches, such as irradiation and pharmacological therapy, are required. In recent years, the use of pituitary irradiation has declined. The technique is commonly associated with adverse effects, including hypopituitarism. ...
Source: www.sandostatin.com
Can medical treatment be used instead of surgery for Acromegaly ?
Occasionally. If the patient cannot undergo surgery, medical treatment, preferably with octreotide, is used. Again, this is not a cure; medical treatment controls the problem.
Source: www.cushings-help.com
Occasionally, but not usually. Most patients have a macroadenoma (tumor greater than 1 cm) at the time of diagnosis. In this situation, surgery to remove as much of the tumor as possible is usually the first treatment. This is particularly important if the tumor is close to the eye nerves (optic chiasm). If the patient cannot undergo surgery, or there is no clear benefit of surgery, medical treatment, preferably with Sandostatin, is used. ...
Source: www.pituitarysociety.org
Occasionally, but not usually. Most patients have a macroadenoma (tumor > 1 cm) at the time of diagnosis. In this situation, surgery to remove as much of the tumor as possible is usually the first treatment. This is particularly important if the tumor is close to the eye nerves (optic chiasm). If the patient cannot undergo surgery, medical treatment, preferably with Sandostatin, is used. ...
Source: www.healthsystem.virginia.edu
