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肢端肥大症:中欧、东欧、以色列和哈萨克斯坦的临床护理。

Acromegaly: Clinical Care in Central and Eastern Europe, Israel, and Kazakhstan.

机构信息

Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland.

Division of Endocrinology and Metabolism, Bar Ilan Faculty of Medicine, Clalit Medical Health Care Services, Safed, Israel.

出版信息

Front Endocrinol (Lausanne). 2022 Feb 22;13:816426. doi: 10.3389/fendo.2022.816426. eCollection 2022.

Abstract

Acromegaly is a rare condition typically caused by benign pituitary adenomas, resulting in excessive production of growth hormone. Clinical manifestations of acromegaly are diverse, varying from the overgrowth of body tissue to cardiovascular, metabolic, and osteoarticular disorders. Symptoms may emerge slowly, overlapping with other diseases and often involve many different healthcare specialists. In the last decade, efforts to provide an accurate and timely diagnosis of acromegaly have improved disease management and clinical experience. Despite this progress, marked differences in the diagnosis, treatment, and management of acromegaly exist from country-to-country. To address these inconsistencies in the region comprising Central and Eastern Europe, Israel, and Kazakhstan, a panel of acromegaly experts from 13 of these countries was convened. Acromegaly experts from each country provided available information on the approaches from their country, including regional treatment centers and multidisciplinary teams, treatment access, reimbursement and availability, and physician education, disease awareness, and patient advocacy. Across several areas of acromegaly management, divergent approaches were identified and discussed, including the provision of multidisciplinary care, approved and available treatments, and disease awareness programs. These were recognized as areas of potential improvement in the management of acromegaly, in addition to participation in national and regional acromegaly registries. Further experience exchange will facilitate the identification of specific strategies that can be adapted in each country, and widespread participation in acromegaly registries will enable their evaluation. It is anticipated that this approach will support the optimization of acromegaly patient care across this region.

摘要

肢端肥大症是一种罕见的疾病,通常由良性垂体腺瘤引起,导致生长激素过度产生。肢端肥大症的临床表现多种多样,从身体组织过度生长到心血管、代谢和骨关节炎疾病不等。症状可能缓慢出现,与其他疾病重叠,并且通常涉及许多不同的医疗保健专家。在过去的十年中,为了提供对肢端肥大症的准确和及时诊断,已经改善了疾病管理和临床经验。尽管取得了这一进展,但肢端肥大症的诊断、治疗和管理在国家之间存在显著差异。为了解决包括中东欧、以色列和哈萨克斯坦在内的该地区的这些不一致性,召集了来自 13 个国家的肢端肥大症专家小组。每个国家的肢端肥大症专家提供了来自其国家的方法的可用信息,包括区域治疗中心和多学科团队、治疗途径、报销和可用性以及医生教育、疾病意识和患者宣传。在肢端肥大症管理的几个领域中,确定并讨论了不同的方法,包括提供多学科护理、批准和可用的治疗方法以及疾病意识项目。除了参与国家和区域肢端肥大症登记处外,这些都被认为是改善肢端肥大症管理的潜在领域。进一步的经验交流将促进确定可以在每个国家采用的具体策略,并且广泛参与肢端肥大症登记处将能够对其进行评估。预计这种方法将支持优化该地区的肢端肥大症患者护理。

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本文引用的文献

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A Pituitary Society update to acromegaly management guidelines.垂体学会关于肢端肥大症管理指南的更新。
Pituitary. 2021 Feb;24(1):1-13. doi: 10.1007/s11102-020-01091-7. Epub 2020 Oct 20.

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