Risks Associated to Therapeutic Inertia in the Management of Acromegaly.

Abstract

Acromegaly is a chronic systemic disease, with a long clinical history, requiring a holistic approach to fully understand patient issues: the longer the time of disease activity, the greater will be the severity and number of complications. The duration of active disease is the major determinant of the onset and progression of complications. The variables that contribute to determine a decline in the quality of life of these patients are numerous and include disease duration, heterogeneity of complications, social context, and treatments. Complications are frequently found at the time of diagnosis that, unfortunately, is burdened by a significant delay since the appearance of the first symptoms in the majority of the cases. Normalization of insulin-like growth factor 1 and growth hormone levels, on the contrary, will lead to improvement, sometimes disappearance, of some complications, and the mortality of these patients will be equal to that of the general population. Therefore, improving clinician ability to early diagnose and treat acromegaly is of fundamental importance to improve patient quality and duration of life, as well as to optimize the utilization of Health System resources.