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A brief introduction to acromegaly


Acromegaly is a chronic disease of adulthood resulting from excessive secretion of growth hormone (GH) and the subsequent elevation of insulin-like growth factor-I (IGF-I).1 It is usually caused by a benign tumour in the anterior pituitary gland.2


Acromegaly is equally prevalent in men and women, with a worldwide estimate of 60 cases per million,3 although more recent studies have estimated this number to be higher,and an annual incidence of 3-4 cases per million.​​​​​​​


The mean age of diagnosis is 41–48 years,5 and diagnosis takes an average of 8 years from onset of symptoms.6 If left untreated or unsuccessfully treated, acromegaly is associated with increased mortality and risk of metabolic and cardiovascular complications;1 the mortality rate for patients with uncontrolled acromegaly is approximately 2–3 times higher than that of the general population.7

Signs and symptoms

Acromegaly affects virtually all organs and tissues, causing metabolic, cardiovascular, neurological and musculoskeletal morbidities.7 The clinical signs can result from chronic exposure to the effects of GH and IGF-I and/or a secondary effect of the mass of the tumour.8

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  1. Aron DC, Findling JW, Tyrrell JB. Hypothalamus and pituitary. In: Greenspan FS, Gardner DG., editors. Basic and clinical endocrinology. 6th ed. Lange Medical Books/ McGraw-Hill Medical Publishing Division; 2001. p. 100-162.
  2. Melmed S, Kleinberg D. Anterior pituitary. In: Larsen PR, Kronenberg HM, Melmed S et al., editors. Williams textbook of endocrinology. 10th ed. Philadelphia, Pennsylvania: Saunders (Elsevier); 2003. p. 180-238.
  3. Freda PU. Acromegaly diagnostic pitfalls. The Endocrinologist. 2004; 14(5):277-287.
  4. Schneider HJ, Sievers C, Saller B, et al. High prevalence of biochemical acromegaly in primary care patients with elevated IGF-1 levels. Clin Endocrinol (Oxf) 2008; 69:432.
  5. Mestrón A, Webb SM, Astorga R et al. Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Español de Acromegalia, REA). Eur J Endocrinol. 2004; 151:439-446.
  6. Melmed S. Medical progress: acromegaly. N Engl J Med. 2006;355:2558-73
  7. Clemmons DR, Chihara K, Freda PU et al. Optimizing control of acromegaly: integrating a growth hormone receptor antagonist into the treatment algorithm. J Clin Endocrinol Metab. 2003; 88(10):4759-4767.
  8. Melmed S, Colao A, Barkan A et al. Guidelines for acromegaly management: an update. J Clin Endocrinol Metab. 2009; 94(5):1509-1517.
PP-SOM-GBR-0950. June 2021

Treating acromegaly

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PP-PFE-GBR-2688. December 2020