Download PDF
Exp Clin Endocrinol Diabetes 2021; 129(03): 216-223
DOI: 10.1055/a-1191-2437
Article

Medical Therapy of Acromegaly in Germany 2019 – Data from the German Acromegaly Registry

Marcus Quinkler 
1   Endocrinology in Charlottenburg, Berlin, Germany
,
David Petroff
2   Clinical Trial Centre, University of Leipzig, Leipzig, Germany
,
Ulrich J. Knappe
3   Department of Neurosurgery, Johannes Wesling Hospital, Minden, Germany
,
Jochen Schopohl
4   Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany
,
Anke Tönjes
5   Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
,
Sebastian M. Schmid
6   Institute for Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany
› Author Affiliations Funding: The German Acromegaly Registry is supported by grants from Ipsen Pharma GmbH, Ettlingen, Germany, Novartis Pharma GmbH, Nuremberg, Germany, and from Pfizer Deutschland GmbH, Berlin, Germany.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Context Acromegaly is a rare disease caused by excessive growth hormone (GH) secretion from pituitary adenomas in most cases. If neurosurgical therapy is contraindicated or not sufficient, medical therapy is the second line therapy.

Objective To describe current medical therapy in acromegaly.

Design & Methods Retrospective data analysis from 2732 patients treated in 69 centers of the German Acromegaly Registry. 749 patients were seen within the recent 18 months, of which 420 were on medical therapy (56.1%).

Results 73% of medically treated acromegalic patients had normal/low IGF-1 levels. 57% of patients with non-normalized IGF-1 levels had an IGF-1 value between 1- and 1.25-fold above the upper limit of normal. Most patients (55%) received somatostatin analogs as monotherapy, 12% GH receptor monotherapy, and 9% dopamine agonist therapy. Doses of each medical therapy varied widely, with 120 mg lanreotide LAR every 4 weeks, 30 mg octreotide LAR every 4 weeks, 140 mg pegvisomant per week and 1mg cabergoline per week being the most frequent used regimens. A combination of different medical regimens was used in almost 25% of the patients.

Conclusion The majority of German acromegalic patients receiving medical therapy are controlled according to normal IGF-1 levels.

Key words

Acromegaly - growth hormone - IGF-1 - cabergoline - lanreotide - octreotide - pegvisomant


Publication History

Received: 28 February 2020
Received: 14 May 2020

Accepted: 29 May 2020

Article published online:
30 June 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Colao A, Grasso LFS, Giustina A. et al. Acromegaly. Nat Rev Dis Primers 2019; 5: 20 Epub 2019/03/23.
    CrossrefPubMedSearch in Google Scholar
  • 2 Schofl C, Petroff D, Tonjes A. et al. Incidence of myocardial infarction and stroke in acromegaly patients: results from the German Acromegaly Registry. Pituitary 2017; 20: 635-642 Epub 2017/08/16.
    CrossrefPubMedSearch in Google Scholar
  • 3 Clayton PE, Banerjee I, Murray PG. et al. Growth hormone, the insulin-like growth factor axis, insulin and cancer risk. Nat Rev Endocrinol 2011; 7: 11-24. Epub 2010/10/20.
    CrossrefPubMedSearch in Google Scholar
  • 4 Giustina A, Barkan A, Beckers A. et al. A Consensus on the diagnosis and treatment of acromegaly comorbidities: An update. J Clin Endocrinol Metab 2019; Epub 2019/10/14.
    CrossrefPubMedSearch in Google Scholar
  • 5 Colao A, Grasso LFS, Di Cera M. et al. Association between biochemical control and comorbidities in patients with acromegaly: An Italian longitudinal retrospective chart review study. J Endocrinol Invest 2019; Epub 2019/11/20.
    CrossrefPubMedSearch in Google Scholar
  • 6 Melmed S, Bronstein MD, Chanson P. et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol 2018; 14: 552-561. Epub 2018/07/28.
    CrossrefPubMedSearch in Google Scholar
  • 7 Schofl C, Franz H, Grussendorf M. et al. Long-term outcome in patients with acromegaly: analysis of 1344 patients from the German Acromegaly Register. Eur J Endocrinol 2013; 168: 39-47 Epub 2012/10/23.
    CrossrefPubMedSearch in Google Scholar
  • 8 Reincke M, Petersenn S, Buchfelder M. et al. The German Acromegaly Registry: description of the database and initial results. Exp Clin Endocrinol Diabetes 2006; 114: 498-505 Epub 2006/11/23.
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Petersenn S, Buchfelder M, Reincke M. et al. Results of surgical and somatostatin analog therapies and their combination in acromegaly: A retrospective analysis of the German Acromegaly Register. Eur J Endocrinol 2008; 159: 525-532 Epub 2008/08/30.
    CrossrefPubMedSearch in Google Scholar
  • 10 Petersenn S, Buchfelder M, Gerbert B. et al. Age and sex as predictors of biochemical activity in acromegaly: Analysis of 1485 patients from the German Acromegaly Register. Clin Endocrinol (Oxf) 2009; 71: 400-405. Epub 2009/02/20.
    CrossrefPubMedSearch in Google Scholar
  • 11 Petroff D, Tonjes A, Grussendorf M. et al. The incidence of cancer among acromegaly patients: Results From the German Acromegaly Registry. J Clin Endocrinol Metab 2015; 100: 3894-3902 Epub 2015/08/06.
    CrossrefPubMedSearch in Google Scholar
  • 12 Knappe UJ, Petroff D, Quinkler M. et al. Fractionated radiotherapy and radiosurgery in acromegaly: analysis of 352 patients from the German Acromegaly Registry. Eur J Endocrinol 2020; 182: 275-284 Epub 2020/01/10..
    CrossrefPubMedSearch in Google Scholar
  • 13 Holdaway IM, Bolland MJ, Gamble GD. A meta-analysis of the effect of lowering serum levels of GH and IGF-I on mortality in acromegaly. Eur J Endocrinol 2008; 159: 89-95 Epub 2008/06/06.
    CrossrefPubMedSearch in Google Scholar
  • 14 Brabant G. Insulin-like growth factor-I: marker for diagnosis of acromegaly and monitoring the efficacy of treatment. Eur J Endocrinol 2003; 148 Suppl 2 S15-S20 Epub 2003/04/03..
    CrossrefPubMedSearch in Google Scholar
  • 15 Giustina A, Chanson P, Bronstein MD. et al. A consensus on criteria for cure of acromegaly. J Clin Endocrinol Metab 2010; 95: 3141-3148 Epub 2010/04/23.
    CrossrefPubMedSearch in Google Scholar
  • 16 Schofl C, Grussendorf M, Honegger J. et al. Failure to achieve disease control in acromegaly: cause analysis by a registry-based survey. Eur J Endocrinol 2015; 172: 351-356 Epub 2015/01/21.
    CrossrefPubMedSearch in Google Scholar