Feature Article

Medical management of acromegaly: a growth area

Feature Article

Medical management of acromegaly: a growth area

Annabelle Warren, Nirupa Sachithanandan

Figures

© ZEPHYR/SPL
© ZEPHYR/SPL

Abstract

Acromegaly is a rare condition of the pituitary gland that may go undetected for many years because clinical presentations, particularly in adults, are subtle. Screening to detect an elevated insulin-like growth factor 1 level can confirm the diagnosis and surgery can offer the best chance of cure. When surgery is unsuccessful or contraindicated, a new generation of recently PBS-listed medications offer alternative effective treatment options to patients.

Key Points

  • Acromegaly is a rare condition, often associated with a significant delay in diagnosis.
  • Uncontrolled acromegaly causes significant morbidity and an average 10-year reduction in life expectancy.
  • Surgery is the recommended first-line treatment.
  • A growing number of medical therapies are available for patients in whom surgery is unsuccessful or contraindicated, including somatostatin receptor ligands (octreotide, lanreotide, pasireotide), a dopamine agonist (cabergoline) and a newer growth hormone receptor antagonist (pegvisomant), which can achieve a hormonal response in up to 95% of patients.