title: LIMITATIONS OF CURRENT APPROACHES FOR THE TREATMENT OF ACROMEGALY.
abstract: OBJECTIVE
  Acromegaly is a rare disease characterized by hypersecretion of growth hormone (GH), typically from a benign pituitary somatotroph adenoma, that leads to subsequent hypersecretion of insulin-like growth factor 1 (IGF-1). Patients with acromegaly have an increased risk of mortality and progressive worsening of comorbidities. Surgery, medical therapy, and radiotherapy are currently available treatment approaches for patients with acromegaly, with overall therapeutic goals of lowering GH levels and achieving normal IGF-1 levels, reducing tumor size, improving comorbidities, and minimizing mortality risk. Although surgery can lead to biochemical remission in some patients with acromegaly, many patients will continue to have uncontrolled disease and require additional treatment.
  
  
  METHODS
  We reviewed recently published reports and present a summary of the safety and efficacy of current treatment modalities for patients with acromegaly.
  
  
  RESULTS
  A substantial proportion of patients who receive medical therapy or radiotherapy will have persistently elevated GH and/or IGF-1. Because of the serious health consequences of continued elevation of GH and IGF-1, there is a need to improve therapeutic approaches to optimize biochemical control, particularly in high-need patient populations for whom current treatment options provide limited benefit.
  
  
  CONCLUSIONS
  This review discusses current treatment options for patients with acromegaly, limitations associated with each treatment approach, and areas within the current treatment algorithm, as well as patient populations for which improved therapeutic options are needed. Novel agents in development were also highlighted, which have the potential to improve management of patients with uncontrolled or persistent acromegaly.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Shanik
mesh_terms: D000172:Acromegaly / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003937:Diagnosis, Differential; D018491:Dopamine Agonists / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D013507:Endocrine Surgical Procedures / Q000379:methods / Q000639:trends; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D010347:Patient Care Planning; D013004:Somatostatin / Q000627:therapeutic use
chemical_list: D018491:Dopamine Agonists; D013004:Somatostatin