Clinical characteristics and efficacy of acromegaly treatment in the Udmurt Republic

Abstract

Background: Acromegaly is a severe neuroendocrine disorder caused by chronic overproduction of growth hormone and insulin-like growth factor 1 and associated with a variety of clinical manifestations, debilitating complications and progressive disability, if no biochemical control has been achieved. The Russian registry of hypothalamic-pituitary tumors allows for evaluation of the epidemiological, demographic and clinical characteristics of patients with acromegaly, as well as of the effectiveness of various treatment methods. Aim: To identify epidemiological and clinical characteristics and treatment efficacy for acromegaly in the patients in the Udmurt Republic. Materials and methods: We performed a cross-sectional study based on the registry of hypothalamic-pituitary tumors of the Udmurt Republic as per June 2022. It contains data from 77 patients with acromegaly. The study included 59 (76.62%) patients with the information sufficient for evaluation of the disease stage and its complications. Results: According to the registry of hypothalamic-pituitary tumors, the prevalence of acromegaly in the Udmurt Republic was 6.71 cases per 100,000 of the population. Patients with acromegaly in Udmurt Republic had a high prevalence of arthralgia, abnormally large feet and hands, weakness/fatigue, snoring / sleep apnea, increased sweating, dizziness, peripheral edema, obesity, menstrual cycle abnormalities, diabetes mellitus, nodular goiter, pathological fractures and hypopituitarism. Neurosurgery has been performed in 74.57% (n = 44) of the patients, with a remission of acromegaly achieved in 18 (40.9%). Medical treatment was given to 25/59 (42.37%) of the patients, with 22 of them being treated with 1st generation long-acting somatostatin analogues. Radiation therapy has been administered to 13 patients (22.03%). Biochemical control was achieved in 40/59 (67.8%) of patients with acromegaly, related to neurosurgery in most patients, as well as to the use of a growth hormone receptor antagonist and/or combined medical treatment. Conclusion: The prevalence of acromegaly in the Udmurt Republic is consistent with international data. Clinical characteristics of acromegaly generally correspond to the classic disease course, although a number of symptoms are more commonly found in the Udmurt Republic patients than in the Russian Federation registry; this might be related to the quality of the registry management. The effectiveness of treatment for acromegaly in Udmurt Republic is comparable to the international data.