The effectiveness of acromegaly treatment according to the Registry of patients with pituitary tumors in the Republic of Tatarstan

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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 Federation

B. 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 Federation

R. 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 Federation

A. 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 Federation

Iu. 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 Federation

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Copyright (c) 2021 Vagapova G.R., Pashaev B.Y., Ashimova R.R., Khafizov A.R., Mokhova I.V.

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