title: A practical approach to acromegaly management in Latin America.
abstract: BACKGROUND
  Evidence-based treatment guidelines have undoubtedly advanced medical practice and supported optimal management of acromegaly, but their application may be hampered by limited access to the latest treatment options.
  
  
  METHODS
  In this retrospective, narrative review, the authors revisited existing treatment guidelines for acromegaly in Latin America. These were considered in conjunction with published evidence chosen at the authors' discretion.
  
  
  RESULTS
  In a socially and economically diverse region, such as Latin America, any regional practice guidelines need to appreciate that recommended treatment options, such as surgery by expert pituitary surgical teams and drug therapies, especially somatostatin analogs, are often not available due to limited resources. In these instances, physicians may be obliged to apply less effective therapeutic options.
  
  
  CONCLUSIONS
  The current article looks at the practical aspects of acromegaly management in Latin America and discusses this in the context of existing guidelines. Furthermore, we consider potential strategies to make better use of resources through combination and multimodal approaches to treatment.
authors.affiliation: Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho, 255, 7ºandar, sala 7037, São Paulo, CEP 05403-000, Brazil, mdbronstein@uol.com.br.
authors.forename: Marcello D
authors.initials: MD
authors.lastname: Bronstein
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Bruno
authors.forename: Alin
authors.initials: A
authors.lastname: Abreu
authors.forename: Ruth
authors.initials: R
authors.lastname: Mangupli
authors.forename: Moisés
authors.initials: M
authors.lastname: Mercado
mesh_terms: D000172:Acromegaly / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D057210:Delayed Diagnosis; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D013004:Somatostatin