F1000Research 2015, 4(F1000 Faculty Rev):1426 Last updated: 15 FEB 2016
REVIEW
Recent advances in the management of acromegaly [version 1; referees: 2 approved] Georgia Ntali1, Niki Karavitaki2 1Department of Endocrinology and Diabetes, Alexandra Hospital, 80 Vas. Sofias St, Athens, 11528, Greece 2Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Wolfson Drive,
Edgbaston, Birmingham, B15 2TT, UK
v1
First published: 11 Dec 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1)
Open Peer Review
Latest published: 11 Dec 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1)
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Abstract Acromegaly is a rare condition of GH excess associated with significant morbidities (e.g. hypertension, glucose intolerance or diabetes mellitus, cardiac, cerebrovascular, respiratory disease and arthritis) and, when uncontrolled, high mortality. Surgery, medical treatment and radiotherapy remain our therapeutic tools. Advances in these options during the last years have offered further perspectives in the management of patients and particularly those with challenging tumours; the impact of these on the long-term morbidity and mortality remains to be assessed.
Invited Referees
1
2
version 1 published 11 Dec 2015
F1000 Faculty Reviews are commissioned from members of the prestigious F1000 Faculty. In order to make these reviews as
This article is included in the F1000 Faculty
comprehensive and accessible as possible,
Reviews channel.
peer review takes place before publication; the referees are listed below, but their reports are not formally published. 1 Maria Fleseriu, Oregon Health & Science University USA 2 Maria Zatelli, University of Ferrara Italy
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F1000Research 2015, 4(F1000 Faculty Rev):1426 Last updated: 15 FEB 2016
Corresponding author: Niki Karavitaki ([email protected]) How to cite this article: Ntali G and Karavitaki N. Recent advances in the management of acromegaly [version 1; referees: 2 approved] F1000Research 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1) Copyright: © 2015 Ntali G and Karavitaki N. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Grant information: The author(s) declared that no grants were involved in supporting this work. Competing interests: The authors declare that they have no disclosures. First published: 11 Dec 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1)
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F1000Research 2015, 4(F1000 Faculty Rev):1426 Last updated: 15 FEB 2016
Introduction Acromegaly is a rare condition characterized by growth hormone (GH) excess and elevated insulin growth factor 1 (IGF-1) levels attributed in the vast majority of cases to a pituitary adenoma. Mortality is high in uncontrolled disease (standardized mortality ratio [SMR]: 0.94–2.5)1–3, but adequate biochemical control can restore it to normal (SMR: 0.44–1.13)1–3. Early diagnosis and treatment, close monitoring, and control of co-morbidities play a major role in the optimal management of these patients. Based on the recently published Endocrine Society Clinical Practice Guideline on acromegaly, therapeutic goals include an age-normalized serum IGF-1 value and a random GH level
REVIEW
Recent advances in the management of acromegaly [version 1; referees: 2 approved] Georgia Ntali1, Niki Karavitaki2 1Department of Endocrinology and Diabetes, Alexandra Hospital, 80 Vas. Sofias St, Athens, 11528, Greece 2Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Wolfson Drive,
Edgbaston, Birmingham, B15 2TT, UK
v1
First published: 11 Dec 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1)
Open Peer Review
Latest published: 11 Dec 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1)
Referee Status:
Abstract Acromegaly is a rare condition of GH excess associated with significant morbidities (e.g. hypertension, glucose intolerance or diabetes mellitus, cardiac, cerebrovascular, respiratory disease and arthritis) and, when uncontrolled, high mortality. Surgery, medical treatment and radiotherapy remain our therapeutic tools. Advances in these options during the last years have offered further perspectives in the management of patients and particularly those with challenging tumours; the impact of these on the long-term morbidity and mortality remains to be assessed.
Invited Referees
1
2
version 1 published 11 Dec 2015
F1000 Faculty Reviews are commissioned from members of the prestigious F1000 Faculty. In order to make these reviews as
This article is included in the F1000 Faculty
comprehensive and accessible as possible,
Reviews channel.
peer review takes place before publication; the referees are listed below, but their reports are not formally published. 1 Maria Fleseriu, Oregon Health & Science University USA 2 Maria Zatelli, University of Ferrara Italy
Discuss this article Comments (0)
F1000Research Page 1 of 8
F1000Research 2015, 4(F1000 Faculty Rev):1426 Last updated: 15 FEB 2016
Corresponding author: Niki Karavitaki ([email protected]) How to cite this article: Ntali G and Karavitaki N. Recent advances in the management of acromegaly [version 1; referees: 2 approved] F1000Research 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1) Copyright: © 2015 Ntali G and Karavitaki N. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Grant information: The author(s) declared that no grants were involved in supporting this work. Competing interests: The authors declare that they have no disclosures. First published: 11 Dec 2015, 4(F1000 Faculty Rev):1426 (doi: 10.12688/f1000research.7043.1)
F1000Research Page 2 of 8
F1000Research 2015, 4(F1000 Faculty Rev):1426 Last updated: 15 FEB 2016
Introduction Acromegaly is a rare condition characterized by growth hormone (GH) excess and elevated insulin growth factor 1 (IGF-1) levels attributed in the vast majority of cases to a pituitary adenoma. Mortality is high in uncontrolled disease (standardized mortality ratio [SMR]: 0.94–2.5)1–3, but adequate biochemical control can restore it to normal (SMR: 0.44–1.13)1–3. Early diagnosis and treatment, close monitoring, and control of co-morbidities play a major role in the optimal management of these patients. Based on the recently published Endocrine Society Clinical Practice Guideline on acromegaly, therapeutic goals include an age-normalized serum IGF-1 value and a random GH level
