Email this article The effectiveness of acromegaly treatment according to the Registry of patients with pituitary tumors in the Republic of Tatarstan
- Authors: Vagapova G.R.1,2, Pashaev B.Y.2,3, Ashimova R.R.1, Khafizov A.R.1, Mokhova I.V.1
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Affiliations:
- Kazan State Medical Academy - Branch Campus of the Russian Medical Academy of Continuous Professional Education
- Interregional Clinical Diagnostic Center
- Kazan State Medical University
- Issue: Vol 49, No 4 (2021)
- Pages: 254-260
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/1541
- DOI: https://doi.org/10.18786/2072-0505-2021-49-040
- ID: 1541
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Abstract
Background: Acromegaly is a severe progressive neuroendocrine disease caused by chronic elevated concentrations of growth hormone and insulin-like growth factor 1 in individuals with completed physiological growth and leading to early disability and mortality. The Acromegaly Registry with its regular updates makes it possible to merge and systematize all the available information on the diseases, to assess the efficacy of treatment algorithms and to choose an optimal diagnostic and treatment strategy in a given territory.
Aim: To evaluate the efficacy of various treatments for acromegaly based on the analysis of the regional Registry of patients with pituitary tumors in the Republic of Tatarstan.
Materials and methods: The study was based on data from 217 patients with somatotropin producing pituitary adenomas entered in the Registry of patients with pituitary tumors in the Republic of Tatarstan as per January 2021. One hundred and eighty one (181 patients) with sufficient data to assess the remission rates and the disease course were included into the analysis.
Results: Endonasal endoscopic adenomectomy as a first-line treatment has been performed in 93% (169/181) of the patients, with 34% of the cases (57/169) being in the full postoperative remission. The efficacy of surgical treatment depended on the tumor size, invasion grade and aggressiveness. A 1st generation long-acting somatostatin analog (octreotide) has been prescribed to 50% (91/181) of the patients (11 patients as first-line therapy and 80 patients after adenomectomy), with biochemical remission rate of 56% (51/91). Radiological treatment has been completed in 11,6% (21/181) of the patients. The complete remission rate after all treatment modalities (surgical, medical, and radiation therapy) was 60% (108/181).
Conclusion: The effectiveness of treatment for acromegaly in the Republic of Tatarstan is comparable to that in the all-Russian and international registries. Nevertheless, 40% of the patients with acromegaly in the region do not have their disease biochemically controlled indicating the need to optimize drug treatment.
About the authors
G. R. Vagapova
Kazan State Medical Academy - Branch Campus of the Russian Medical Academy of Continuous Professional Education; Interregional Clinical Diagnostic Center
Author for correspondence.
Email: g.r.vagapova@gmail.com
ORCID iD: 0000-0001-8493-7893
Gulnar R. Vagapova - MD, PhD, Professor, Head of Chair of Endocrinology, Kazan State Medical Academy - Branch Campus of the Russian Medical Academy of Continuous Professional Education; Endocrinologist, Interregional Clinical Diagnostic Center.
12 Karbysheva ul., Kazan, 420101.
Tel.: + 7 (917) 269 59 28.
Russian FederationB. Yu. Pashaev
Interregional Clinical Diagnostic Center; Kazan State Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0003-3702-7488
Bakhtiyar Yu. Pashaev – Neurosurgeon, Interregional Clinical Diagnostic Center; Assistant Professor, Chair of Neurology and Neurosurgery, Faculty of Advanced Training and Staff Retraining, Kazan State Medical University.
12A Karbysheva ul., Kazan, 420101; 49 Butlerova ul., Kazan, 420012.
Russian FederationR. R. Ashimova
Kazan State Medical Academy - Branch Campus of the Russian Medical Academy of Continuous Professional Education
Email: fake@neicon.ru
ORCID iD: 0000-0003-3342-9412
Regina R. Ashimova - Resident Physician, Chair of Endocrinology.
11 Mushtari ul., Kazan, 420012.
Russian FederationA. R. Khafizov
Kazan State Medical Academy - Branch Campus of the Russian Medical Academy of Continuous Professional Education
Email: fake@neicon.ru
ORCID iD: 0000-0002-1448-4945
Artur R. Khafizov - Resident Physician, Chair of Endocrinology1.
11 Mushtari ul., Kazan, 420012.
Russian FederationIu. V. Mokhova
Kazan State Medical Academy - Branch Campus of the Russian Medical Academy of Continuous Professional Education
Email: fake@neicon.ru
ORCID iD: 0000-0002-1329-7953
Iullia V. Mokhova - Resident Physician, Chair of Endocrinology.
11 Mushtari ul., Kazan, 420012.
Russian FederationReferences
- Белая ЖЕ, Голоунина ОО, Рожинская ЛЯ, Мельниченко ГА, Исаков МА, Луценко АС, Алексеева ТМ, Зенкова ТС, Пржиялковская ЕГ, Панюшкина ГМ, Илюхина ОБ, Иванова ЕИ, Кришталь ЕА, Вачугова АА, Пигарова ЕА, Дзеранова ЛК, Марова ЕИ, Арапова СД, Мамедова ЕО, Гребенникова ТА, Анциферов МБ, Древаль АВ, Дедов ИИ. Эпидемиология, клинические проявления и эффективность различных методов лечения акромегалии по данным единого российского регистра опухолей гипоталамо-гипофизарной системы. Проблемы Эндокринологии. 2020;66(1):93-103. doi: 10.14341/probl10333.
- Lavrentaki A, Paluzzi A, Wass JA, Karavitaki N. Epidemiology of acromegaly: review of population studies. Pituitary. 2017;20(1):4-9. doi: 10.1007/s11102-016-0754-x.
- Дедов ИИ, Молитвословова НН, Рожинская ЛЯ, Мельниченко ГА. Федеральные клинические рекомендации по клинике, диагностике, дифференциальной диагностике и методам лечения акромегалии. Проблемы Эндокринологии. 2013;59(6): 4-18. doi: 10.14341/probl20135964-18.
- Fleseriu M, Biller BMK, Freda PU, Gadelha MR, Giustina A, Katznelson L, Molitch ME, Samson SL, Strasburger CJ, van der Lely AJ, Melmed S. A Pituitary Society update to acromegaly management guidelines. Pituitary. 2021;24(1):1-13. doi: 10.1007/s11102-020-01091-7.
- Maione L, Chanson P. National acromegaly registries. Best Pract Res Clin Endocrinol Metab. 2019;33(2):101264. doi: 10.1016/j.beem.2019.02.001.
- Территориальный орган Федеральной службы государственной статистики по Республике Татарстан. Численность населения муниципальных районов и городских округов Республики Татарстан на начало 2021 г. и в среднем за 2020 г. [Интернет]. 23.03.2021. Доступно на: https://tatstat.gks.ru/naselenie.
- Астафьева ЛИ, Воронцов АВ, Воротникова СЮ, Григорьев АЮ, Дедов ИИ, Дзеранова ЛК, Кадашев БА, Липатенкова АК, Мельниченко ГА, Пигарова ЕА. Инциденталомы гипофиза: национальные клинические рекомендации. М., 2016.
- Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. 1993;33(4):610-617; discussion 617-618. doi: 10.1227/00006123-199310000-00008.
- Casanueva FF, Barkan AL, Buchfelder M, Klibanski A, Laws ER, Loeffler JS, Melmed S, Mortini P, Wass J, Giustina A; Pituitary Society, Expert Group on Pituitary Tumors. Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement. Pituitary. 2017;20(5):489-498. doi: 10.1007/s11102-017-0838-2.
- Zahr R, Fleseriu M. Updates in Diagnosis and Treatment of Acromegaly. Eur Endocrinol. 2018;14(2):57-61. doi: 10.17925/EE.2018.14.2.57.
- Corica G, Ceraudo M, Campana C, Nista F, Cocchiara F, Boschetti M, Zona G, Criminelli D, Ferone D, Gatto F. Octreotide-Resistant Acromegaly: Challenges and Solutions. Ther Clin Risk Manag. 2020;16:379-391. doi: 10.2147/TCRM.S183360.
- Wilson TJ, McKean EL, Barkan AL, Chandler WF, Sullivan SE. Repeat endoscopic transsphenoidal surgery for acromegaly: remission and complications. Pituitary. 2013;16(4):459-464. doi: 10.1007/s11102-012-0457-x.
- Giustina A, Barkhoudarian G, Beckers A, Ben-Shlomo A, Biermasz N, Biller B, Boguszewski C, Bolanowski M, Bollerslev J, Bonert V, Bronstein MD, Buchfelder M, Casanueva F, Chanson P, Clemmons D, Fleseriu M, Formenti AM, Freda P, Gadelha M, Geer E, Gurnell M, Heaney AP, Ho KKY, Ioachimescu AG, Lamberts S, Laws E, Losa M, Maffei P, Mamelak A, Mercado M, Molitch M, Mortini P, Pereira AM, Petersenn S, Post K, Puig-Domingo M, Salvatori R, Samson SL, Shimon I, Strasburger C, Swearingen B, Trainer P, Vance ML, Wass J, Wierman ME, Yuen KCJ, Zatelli MC, Melmed S. Multidisciplinary management of acromegaly: A consensus. Rev Endocr Metab Disord. 2020;21(4):667-678. doi: 10.1007/s11154-020-09588-z.
- Иловайская ИА. Современный взгляд на лечение акромегалии аналогами соматостатина. Медицинский Совет. 2017;(3): 75-79. doi: 10.21518/2079-701X-2017-3-75-79.
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