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Endocrine Abstracts (2021) 73 JS4.1 | DOI: 10.1530/endoabs.73.JS4.1

Division of Endocrinology and Metabolism, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.


Acromegaly is a chronic disease caused almost invariably by a pituitary GH-secreting adenoma leading to overproduction of insulin-like growth factor I (IGF-I). The long-term hypersecretion leads to many comorbidities, as diabetes mellitus, arterial hypertension, and cardiovascular and/or pulmonary disease (including sleep apnea), which are related to an increased mortality rate. In fact, uncontrolled acromegaly is associated with a three times mortality rate as compared with normal population. Treatment of acromegaly can restore mortality rate to that of normal population. Transsphenoidal pituitary surgery is considered the first treatment option for most cases, being first generation somatostatin receptor ligands (SRL- octreotide LAR or lanreotide Autogel) and second generation SRL ( pasireotide LAR), among other drugs, reserved for uncontrolled patients after surgery and for those to whom surgical procedure is not indicated. Therefore, it is of note that patients with uncontrolled acromegaly harbor the same comorbitities associated with poor prognosis for COVID-19 pandemics caused by SAR-COV-2 virus. Therefore, is crucial that acromegaly should be controlled, especially regarding the COVID-19 pandemics. Concerning medical treatment, an increase of QTc interval is a possible side effect of SRL's, the main class of drugs used to treat acromegaly. Also drugs that have been proven to be inefficacious for COVID-19 prevention/treatment but still used as chloroquine and azithromycin and its association may prolong QTc intervals. Considering that acromegaly itself can increase QTc interval and risk of arrhythmias, the use of the above mentioned drugs should be avoided or strictly monitored. Also the hyperglycemic effect of SRL's, especially pasireotide, should be considered. The impact of COVID-19 pandemics in acromegaly care is of relevance. Pituitary surgery has been frequently postponed, either due to risk of virus transmission or to lack of hospital availability. Also the monthly visit to medical facilities to get SRL's injections shot has been severely compromised. Therefore, patients and health care staff need to be adapted to these changes in order to keep the disease and comorbidities controlled and to prevent acute illnesses such COVID-19 by vaccination and safety measures as masks and social isolation.

Volume 73

European Congress of Endocrinology 2021

Online
22 May 2021 - 26 May 2021

European Society of Endocrinology 

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