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Long-term real-life outcomes in a georrefered cohort of acromegalic patients in Brazil

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Abstract

Purpose

Epidemiological data on acromegaly therapeutic outcomes in real-life conditions are scarce in Brazil. Information on the geographical accessibility to the dispensation of medicines and its impact on biochemical control is also poorly known. We aimed to describe the clinical outcomes of long-term therapy in patients with acromegaly at a referral medical centre in Brazil and to perform a spatial analysis of patients according to the distance from home to the drug-dispensing pharmacies aiming to evaluate its impact on biochemical control.

Methods

Global retrospective data analysis of 111 patients followed at the University Hospital of Brasília from January 1980 to March 2015 was performed, as well as a separate review of 17 new cases operated on from April 2015 to June 2019 according to surgery results. Spatial analysis of patients under pharmacological treatment applying Geographic Information System (GIS) software (ArcGIS, ESRI, Redlands, CA) was performed.

Results

Considering surgery alone, the cure rate was 23% from 1980 to 2015 and 29.4% from 2015 to 2019. In the long-term follow-up of the 111 patients from 1980 to 2015, 25.2% (n = 29) were cured, 40.6% (n = 44) presented controlled disease and 34.2% (n = 38) were biochemically uncontrolled after a period of follow-up of 8.9 ± 6.4 years. Biochemical control obtained in patients on pharmacological treatment (n = 76) was 58% (n = 44) after 5.8 ± 3.8 years. The distance from home to the drug-dispensing pharmacy did not influence biochemical control (p = 0.7616).

Conclusions

Most patients presented with disease under control. No evidence on the effect of the distance between home and drug-dispensing pharmacies on biochemical control was obtained.

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Acknowledgements

We thank the support of the Nucleus of Support on Research (Nucleo de Apoio a Pesquisa-NAP) from the Sabin Institute and the SABIN laboratory for performing the laboratory tests. We thank Dr Luciana Pinto Valadares, from Hospital Sarah Kubistschek, Dr Luis Augusto Dias and Dr Bernardo Barbosa for clinical and neurosurgical assistance.

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Authors and Affiliations

  1. Unit of Endocrinology, Faculty of Medicine and Post-Graduation Program in Health Sciences, University of Brasilia, Brasilia, Brazil

    Lara Benigno Porto, Luiz Augusto Casulari & Luciana Ansaneli Naves

  2. Unit of Endocrinology of the Regional Hospital of Taguatinga and Research Centre of the Foundation for Education and Research in Health Sciences, Secretariat of Health of the Federal District, Brasilia, Brazil

    Lara Benigno Porto

  3. Institute of Geosciences, University of Brasilia, Brasilia, Brazil

    José Wilson Corrêa Rosa & João Willy Corrêa Rosa

  4. National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil

    Ivan Ricardo Zimmermann

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  1. Lara Benigno Porto
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Correspondence to Lara Benigno Porto.

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The study was performed in accordance with the Declaration of Helsinki and was approved by the local ethics committee.

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Porto, L.B., Rosa, J.W.C., Rosa, J.W.C. et al. Long-term real-life outcomes in a georrefered cohort of acromegalic patients in Brazil. Endocrine 68, 390–398 (2020). https://doi.org/10.1007/s12020-020-02240-5

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