Standards of care for medical management of acromegaly in pituitary tumor centers of excellence (PTCOE)
Authors' conclusion
Current standards of care in PTCOEs include use of first-generation SRLs as the first medical option in about 50% of patients, as recommended by consensus guidelines. However, some patients are kept on this treatment despite inadequate control suggesting that cost-effectiveness, availability, patient preference, side effects, and therapeutic inertia may play a possible role also in PTCOE. Moreover, at odds with consensus guidelines, other monotherapies for acromegaly appear to have a marginal role as compared to combination therapies as extrapolated from PTCOE practice data. Presence of uncontrolled patients in each treatment category suggest that further optimization of medical therapy, as well as use of other therapeutic tools such as radiosurgery may be needed.
Study context
- Population
- Acromegaly patients under medical treatment in nine international pituitary tumor centers of excellence (PTCOE), 2018–20209 centers
- Outcome
- Medical treatment of acromegaly in PTCOEs
- Follow-up
- 2018-2020
Methodological detailsmulticentre, international
- Multicentre
- International
Main finding
As reported in the abstract
- Median number of total acromegaly patients managed annually
- 206
- Median number of new acromegaly patients managed annually
- 16.3
- Median percentage of patients on medical treatment
- 48.9%
- First-generation somatostatin receptor ligand (SRL) monotherapy, median rate among medically treated
- 48.7%
- Combination therapies, median rate
- 29.3%
- Cabergoline monotherapy
- 6.9%
- Pegvisomant monotherapy (used in 7 centers), median rate
- 7.9%
- Pasireotide monotherapy (used in 5 centers), median rate
- 6.3%
Original publication
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