Acromegaly and Available Treatments Today
Acromegaly is a rare disease that develops at the onset of adulthood in individuals and is linked to the increased production of growth hormone (GH) by the pituitary gland. Acromegaly presents itself when benign tumors grow on the pituitary gland, affecting the gland’s normal release of hormones into the bloodstream. This overproduction of GH in the body leads to abnormally long bone growth and growth spurts. The most common observation in people diagnosed with acromegaly is this abnormal growth of the limbs. Other symptoms of acromegaly include the hardening of soft tissue like the tongue, heart, and lips as well as cartilage on the face, enlargement of sinuses, vocal cords, and the jaw.
In addition to changes to external features, acromegaly affects internal organs like the heart, spine, liver and nerves. Many adults present heart failure and increased blood pressure, as well as abnormal curvature of the spine attributed to acromegaly. Additional symptoms include an enlargement of the liver, spleen, thyroid and other glands in the body.
The disease targets males and females in populations equally, and it is estimated that about 60 out of every million people suffer from acromegaly. Blood tests and Magnetic Resonance Imaging (MRI) are used if acromegaly is suspected in a person.
Today, there are many treatment options available for people diagnosed with acromegaly. Treatment mainly aims to bring the production of GH down to normal levels and improve the symptoms of acromegaly in the individual. Surgery is the first and most commonly suggested treatment that removes either full or part of the pituitary tumor tissue to relieve existing pressure surrounding the brain. Following surgery, patients are monitored closely to ensure that hormone levels do not shoot back up.
Another common treatment available is medical therapy, which aims to use medication that inhibits the secretion of GH. Recently, octreotide acetate has been approved by the Food and Drug Administration (FDA) to inhibit the secretion of GH in the body. Somatostatin analogs are also a group of medication drugs that lower GH levels and reduce tumor sizes after injection in patients. The second medication group includes GH receptor antagonists (GHRAs) that interfere with the action of GH after injections prescribed once a day. Dopamine antagonists in the third medication group are often prescribed to patients in combination with other medications like somatostatin analogs.
Radiation therapy is the third type of treatment for patients who have not responded positively to surgery or medication. Conventional fractionated radiation therapy reduces GH levels after daily treatments that are scheduled over a 4-6 week period, while stereotactic delivery targets a high-dose beam of radiation that targets the tumor.
If untreated, the disease leads to an increased risk for a patient to develop cardiovascular disease, diabetes, or hypertension. It is thus important to note that different methods of treatment are effective for different individuals. Often, many of these treatment methods can be combined to cater towards the needs of each patient.
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Cite This Article:
Rao S., Zheng K., Chan G., Ho J. Acromegaly and Available Treatments Today. Rare Disease Review. January 2017. DOI:10.13140/RG.2.2.24777.95843.