Comorbidities and Concomitant Medications in Acromegaly

Recent research has given us a better understanding of acromegaly, a rare hormonal disorder. Conducted by Maria Fleseriu, MD, FACE, and colleagues at the Pituitary Center at Oregon Health & Science University in Portland, this study investigated comorbidities and concomitant medications in adult patients with acromegaly. You can find the full paper here, which was published in Pituitary

About Acromegaly

First, let’s get a better understanding of what this rare disease is. Acromegaly is a hormonal disorder that is characterized by an excess of growth hormone (GH) which causes abnormal and significant growth. Tumors, called adenomas, form on the pituitary gland and release excess GH. Symptoms develop slowly, but when they do become noticeable, they include:

  • Abnormal growth in the hands and feet
  • Protruding lower jaw and brow
  • Enlarged nasal bone
  • Excessive sweating
  • Thick, oily, course skin
  • Enlarged facial features
  • Enlarged organs

It’s important to seek treatment for this condition, as it can become severe and lead to serious complications or even death. Unfortunately, diagnosis can be difficult to make due to slowly progressing symptoms. In fact, patients are often misdiagnosed. When they do receive their acromegaly diagnosis and subsequent treatment, the treatment options are typically surgery to remove the adenomas on the pituitary gland or medications, such as somatostatin analogs (SSAs), GH receptor antagonists (GHRAs), and dopamine agonists.

About the Study

Dr. Fleseriu and the research team wanted to investigate comorbidity frequency and concomitant medication use in a cohort of 1,175 adult acromegaly patients with active disease on medical therapy. They were matched 1:5 to the control group. Additionally, the investigated acromegaly’s relations to other conditions (e.g., sleep apnea, musculoskeletal disorders, hypothalamic disorders, hypopituitarism, arthritis, and malignant neoplasms).

Here’s some of the data that the team found:

  • Acromegaly patients had nearly twice the number of cerebrovascular disorders when compared to the control cohort
  • 89% of acromegaly patients were taking three or more medications
    • Only 2.5% were on no medications
    • This can be compared to 68.3% of the control group on three or more medications and 15% on no medications
    • Researchers observed a moderate positive association between comorbidity frequency and number of concomitant medication ingredients
  • A prevalence of 67.6% of cardiovascular disease in the acromegaly cohort
    • Compare to 48.4% in the control group
  • A prevalence of 26.3% of disorders of hypothalamus and hypopituitarism
    • Compare to 0.2% of the control group
  • A prevalence of 24.9% of sleep apnea
    • Compare to 7.8% of the control group
  • A prevalence of 19.9% of musculoskeletal disorders and arthritis
    • Compare to 12.9% of the control group
  • 70% of acromegaly patients were prescribed more antibacterials for systemic use
    • Compare to 55.6% of the control group
  • 56.3% of acromegaly patients were prescribed more analgesics
    • Compare to 38.1% of the control group
  • 46.4% of acromegaly patients were prescribed more cold and cough preparations
    • Compare to 35.5% of the control group
  • 42.6% of acromegaly patients were prescribed more psycholeptics
    • Compare to 24.8% of the control group
  • 37.3% of acromegaly patients were prescribed more modulators of the genital system and sex hormones
    • Compare to 12.7% of the control group
  • Looking deeper into concomitant medications, 67.9% were oral formulations, 15.1% were injectable formulations, and the remaining 17% took other formulations
  • Every medication evaluated – minus lisinopril – were prescribed more often to acromegaly patients than controls

In addition to this analysis, the research team also investigated acromegaly in its relation to anticoagulants. Their sub-analysis focused on 52 acromegaly patients who were being treated with anticoagulants matched to 131 control participants receiving anticoagulants, alongside 1,123 acromegaly patients who were not being treated with anticoagulants matched to 5,744 controls.

They found that acromegaly patients taking anticoagulants had higher rates of type 2 diabetes and malignant neoplastic disease. Additionally, they found that this group also had a higher prevalence of concomitant injectable medications prescriptions than the other groups.

In the end, this research is extremely helpful in understand the life and landscape surrounding acromegaly patients. Hopefully, it sets up further research that provides us with an even better understanding.

You can find the source article here.

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