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Pituitary

, Volume 14, Issue 3, pp 284–294

First Online: 20 May 2011

Abstract

Although acromegaly is a rare disease, the clinical, economic and health-related quality of life HRQoL burden is considerable due to the broad spectrum of comorbidities as well as the need for lifelong management. We performed a comprehensive literature review of the past 12 years 1998–2010 to determine the benefit of disease control defined as a growth hormone GH concentration <2.5 μg-l and insulin-like growth factor IGF-1 normal for age on clinical, HRQoL, and economic outcomes. Increased GH and IGF-1 levels and low frequency of somatostatin analogue use directly predicted increased mortality risk. Clinical outcome measures that may improve with disease control include joint articular cartilage thickness, vertebral fractures, left ventricular function, exercise capacity and endurance, lipid profile, and obstructive apnea events. Some evidence suggests an association between controlled disease and improved HRQoL. Total direct treatment costs were higher for patients with uncontrolled compared to controlled disease. Costs incurred for management of comorbidities, and indirect cost could further add to treatment costs. Optimizing disease control in patients with acromegaly appears to improve outcomes. Future studies need to evaluate clinical outcomes, as well as HRQoL and comprehensive economic outcomes achieved with controlled disease.

KeywordsAcromegaly Somatostatin analogues Octreotide Lanreotide Quality of life Morbidity Mortality  Download fulltext PDF



Autor: A. Ben-Shlomo - M. C. Sheppard - J. M. Stephens - S. Pulgar - S. Melmed

Fuente: https://link.springer.com/







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