title: Long-term outcome in patients with acromegaly: analysis of 1344 patients from the German Acromegaly Register.
abstract: BACKGROUND
  Acromegaly is a rare disease with significant morbidity and increased mortality. Epidemiological data about therapeutic outcome under 'real life' conditions are scarce.
  
  
  OBJECTIVE
  To describe biochemical long-term outcome of acromegaly patients in Germany.
  
  
  METHODS
  Retrospective data analysis from 1344 patients followed in 42 centers of the German Acromegaly Register. Patients' data were collected 8.6 (range 0-52.6) years after diagnosis. Controlled disease was defined by an IGF1 within the center-specific reference range.
  
  
  RESULTS
  Nine hundred and seventeen patients showed a normalized IGF1 (157 (range 25-443) ng/ml). In patients with a diagnosis dated back >2 years (n=1013), IGF1 was normalized in 76.9%. Of the patients, 19.5% had an elevated IGF1 and a random GH ≥1 ng/ml, 89% of the patients had at least one surgical intervention, 22% underwent radiotherapy, and 43% received medical treatment. After surgery 38.8% of the patients were controlled without any further therapy. The control rates were higher in surgical centers with a higher caseload (P=0.034). Of the patients with adjunctive radiotherapy 34.8% had a normal IGF1 8.86 (0-44.9) years post irradiation, 65.2% of the medically treated patients were controlled, and 47.2% of the patients with an elevated IGF1 received no medical therapy.
  
  
  CONCLUSIONS
  The majority of acromegaly patients were controlled according to their IGF1 status. Long-term outcome could be improved by exploiting medical treatment options especially in patients who are not controlled by surgery and/or radiotherapy.
authors.affiliation: Department of Medicine I, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany. christof.schoefl@uk-erlangen.de
authors.forename: Christof
authors.initials: C
authors.lastname: Schöfl
authors.forename: Holger
authors.initials: H
authors.lastname: Franz
authors.forename: Martin
authors.initials: M
authors.lastname: Grussendorf
authors.forename: Jürgen
authors.initials: J
authors.lastname: Honegger
authors.forename: Cornelia
authors.initials: C
authors.lastname: Jaursch-Hancke
authors.forename: Bernhard
authors.initials: B
authors.lastname: Mayr
authors.forename: Jochen
authors.initials: J
authors.lastname: Schopohl
mesh_terms: D000172:Acromegaly / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007334:Insulin-Like Growth Factor I