Journal
CLINICAL ENDOCRINOLOGY
Volume 79, Issue 1, Pages 79-85Publisher
WILEY
DOI: 10.1111/cen.12112
Keywords
-
Categories
Funding
- Novartis Canada
- Centre de Recherche du Centre Hospitalier de l'Universite de Montreal
Ask authors/readers for more resources
Objective To evaluate demographic data and quality of care of patients with acromegaly in Canada and their evolution over time and secondly, to evaluate predictors of co-morbidities and treatment outcomes. Design and patients Retrospective analyses of clinical, biochemical and treatment outcome data of 649 patients with acromegaly (males: 50 center dot 7%) followed from 1980 to 2010 (mean 10 center dot 2years, SD 13 center dot 7) in eight tertiary care centres from six Canadian provinces. Results In comparison to 1980-1994, the number of patients referred with acromegaly in the last 15years was higher with female preponderance (52 center dot 8% vs 41 center dot 4%, P=0 center dot 01) and an older age at diagnosis (46 center dot 4 +/- 14 vs 41 center dot 3 +/- 12years, P<0 center dot 0001). Diabetes was present in 28%, hypertension in 37% and sleep apnoea in 33% of cases. Pretreatment IGF-1 levels, but not GH levels were significant predictors of diabetes (P=0 center dot 0002) and hypertension (P<0 center dot 0001). Eighty-nine per cent of patients underwent pituitary surgery, 64 center dot 5% had medical therapy and 22% received radiotherapy. Radiotherapy was less utilized in the past 15years (16% vs 45%, P<0 center dot 0001). Multimodal therapy achieved remission or control of acromegaly in 70% of patients. Patients in remission or disease control had lower initial random GH (P=0 center dot 04) and IGF-1 levels (P<0 center dot 0001). Hypopituitarism was present in 23% of patients and cancer in 8 center dot 5%. Conclusions There was an increase over time of referral for acromegaly management with female predilection. Initial higher IGF-1, but not GH levels, were predictive of co-morbidities and persistent active disease after treatment. Disease remission or control was attained in 70% of patients utilizing multimodal therapy.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available