The prevalence of acromegaly is higher than previously reported: Changes over a three-decade period

Objective To study time-related changes in the prevalence and patient characteristics of acromegaly, as well as to assess the impact of changes in treatment on disease control. Methods A total of 107 patients with acromegaly were identified by healthcare registries and subsequently validated by patient chart review over a three-decade period (1992-2021). A systematic literature review focusing on the incidence and prevalence of acromegaly was performed identifying 31 studies. Results The prevalence of acromegaly significantly increased throughout the study period (R-2 = 0.94, p < .001) and was 122 cases/10(6) persons in 2021 whereas the annual incidence remained constant at 4.6 cases/10(6) persons. The age at the first sign of acromegaly and the age at diagnosis significantly increased during the study period, whereas growth hormone and insulin-like growth factor I decreased. Incidentalomas constituted 32% of all cases diagnosed with acromegaly in the last decade. Primary surgery was used in 93% of all cases, and repeated surgery decreased from 24% to 10% during the three decades. The use of first-generation somatostatin analogues (21%-48%) and second-line medical treatment (4%-20%) increased with a concomitant improvement of biochemical disease control (58%-91%). Conclusion The prevalence of acromegaly is higher than previously reported and the clinical presentation has shifted towards a milder phenotype. Modern treatment of acromegaly enables individualized treatment and disease control in the majority of patients.

Automated summary

This study investigated the prevalence and patient characteristics of acromegaly over time, as well as the impact of treatment changes on disease control. The study found that the prevalence of acromegaly has increased significantly, with a shift towards a milder clinical phenotype. Modern treatment approaches enable individualized treatment and disease control in the majority of patients with acromegaly.