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By Ehud Ur Professor and Head, Endocrinology, UBC, Vancouver
Johannes A Romijn
Ultimately, almost all patients who are appropriately treated for pituitary tumours enter a chronic phase with control or cure of hormonal excess, adequate treatment of pituitary insufficiency and relief of mass effects. This phase is associated with improvement of initial signs and symptoms, but also with the persistent consequences of the initial disease and associated treatments. Pituitary insufficiency is a common denominator in many of these patients, and is associated with a reduction in quality of life, despite adequate endocrine substitution...
September 2016: Nature Reviews. Endocrinology
Daniel Cuevas-Ramos, Maria Fleseriu
Morbidity and mortality rates in patients with active acromegaly are higher than the general population. Adequate biochemical control restores mortality to normal rates. Now, medical therapy has an increasingly important role in the treatment of patients with acromegaly. Somatostatin receptor ligands (SRLs) are considered the standard medical therapy, either after surgery or as a first-line therapy when surgery is deemed ineffective or is contraindicated. Overall, octreotide and lanreotide are first-generation SRLs and are effective in ~20%-70% of patients...
2016: Drug Design, Development and Therapy
Jeremy R Anthony, Adriana G Ioachimescu
PURPOSE OF REVIEW: To provide an update on current understanding of osteoporosis associated with acromegaly. RECENT FINDINGS: Patients with acromegaly have an increased risk of morphometric vertebral fractures. This seems to correlate with acromegaly activity and its duration, but it persists after biochemical control is achieved. Coexistent hypogonadism, diabetes mellitus and over-replacement with glucocorticoids have additional detrimental effects. Bone mineral density can be normal, increased or decreased, and is usually discordant with occurrence of fractures...
December 2014: Current Opinion in Endocrinology, Diabetes, and Obesity
Daniel Cuevas-Ramos, John D Carmichael, Odelia Cooper, Vivien S Bonert, Arkadiusz Gertych, Adam N Mamelak, Shlomo Melmed
CONTEXT: GH-secreting pituitary adenomas exhibit heterogeneous natural history ranging from small tumors to large aggressive adenomas. OBJECTIVE: To rigorously classify an acromegaly patient cohort defined by clinical, radiological, histopathological, and outcome characteristics. DESIGN: Cross-sectional study. SETTING: Tertiary referral pituitary center. PATIENTS: Subjects were selected from a pituitary tumor research registry that includes 1178 patients with pituitary disease...
January 2015: Journal of Clinical Endocrinology and Metabolism
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