Mc. Sheppard, Follow-up of treated acromegaly: similarities and differences in assessingthe response to different primary treatment modalities, GROWTH H I, 10, 2000, pp. 115-118
The decreased survival rate previously reported in patients with acromegaly
can be normalized by successful surgical and adjunctive therapy. After sur
gical treatment, however, abnormalities of pulsatile growth hormone (GH) se
cretion may persist in spite of normal insulin-like growth factor I (IGF-I)
levels, and there is a significant relapse rate. Radiotherapy is effective
in lowering GH levels but relatively ineffective in normalizing IGF-I leve
ls. There are very few data on long-term outcome after medical treatment of
acromegaly, although current studies of patients receiving primary medical
therapy will produce further information. IGF-I level may become an increa
singly important biochemical end point. The goal of therapy is to achieve a
biochemical value that reverses both the morbidity and increased mortality
rate without resulting in hypopituitarism, (C) 2000 Harcourt Publishers Lt
d.