Optimization of the follow-up and treatment of patients with acromegaly with the SAGIT^® tool

Abstract

The condition of a patient with acromegaly is significantly influenced not only by growth hormone (GH) and insulin-like growth factor type 1 (IGF-1) levels, but also by specific characteristics of somatotropinoma, severity of the main symptoms of acromegaly, and concomitant disorders. After successful achievement of biochemical control (GH and IGF-1 goals) the expected life longevity in patients with acromegaly could be comparable with that in the general population. It is important to avoid therapeutic inertia, to achieve biochemical control within shortest time period and to carefully tailor the treatment of concomitant disorders. The cumulative experience of patient management has shown that therapeutic decisions should be based not only on measurement of GH and IGF-1 levels, but also on a unified multifactorial assessment of the patient's status. For this purpose, the SAGIT tool has been elaborated, which ensures a multifaceted standardized assessment of patients with acromegaly, taking into account clinical symptoms, hormonal parameters, tumor size and comorbidities. This paper is the first description of the SAGIT tool in Russian. The use of this tool allows for standardization of the patients assessment and for comparison of the status in patients both within one center and in different centers. The key unified information obtained with SAGIT could be the basis for making prompt decisions on the need in treatment optimization for a patient with acromegaly, including his/hers referral to an expert center for the choice of further treatment strategy. The SAGIT tool has been recommended for implementation into clinical practice by international professional associations. It is advisable to perform studies with participation of the Russian patients with acromegaly to assess the possibility of SAGIT implementation into clinical practice in Russia.