Mexico’s acromegaly registry provides insight on treatment differences
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The Mexican Acromegaly Registry, the first non-European registry of the disease and the largest such registry in the world, shows that the availability of resources influences treatment choices in different parts of Mexico, according to researchers.
“The Mexican Acromegaly Epidemiology Program constitutes the largest registry of the disease reported to date and the first to be established in a non-European country,” Lesly A. Portocarrero-Ortiz, MD, of the Instituto Nacional de Neurologia y Neurocirugia, Mexico City, and colleagues wrote. “Our clinical, biochemical and therapeutic outcome data is roughly similar to that reported by the different European registries. Yet, our results reveal significant interinstitutional variations derived from the different availabilities of resources to treat this disease.”
The Mexican Acromegaly Registry (MAR) consists of data for 2,057 patients, 51% of whom are women, diagnosed at a mean age of 41.1 years across 24 participating centers that belong to three different institutions. All cases in the registry, which was created in 2009, were diagnosed after 1990. Patients on the registry also had an assortment of other conditions, including hypertension (27%), glucose intolerance (18.4%), diabetes (30%) and dyslipidemia (24%). The estimated prevalence of acromegaly in Mexico is 18 cases per million inhabitants, based on an estimated population of 119 million.
The Mexican Institute for Social Security was responsible for roughly two thirds of the patients, while about a third received care through the Ministry of Health. A third agency, the Institute for Social Services and Security of Workers of the State, provided care for 8.7% of registered patients.
“Patients followed at [Institute for Social Security] and [the Institute for Social Services and Security of Workers of the State] centers are provided with integral health care services that include pituitary neurosurgery, radiotherapy and high-cost medications, such as somatostatin analogues,” the researchers wrote. “Patients receiving care at hospitals belonging to the [Ministry of Health] have access to skilled neurosurgeons and modern radiotherapy, but are not provided medications.”
More than half of patients received treatment with transsphenoidal surgery (72%), while somatostatin analogues were prescribed as primary treatment to 26% of patients and as adjunctive treatment to 54% of patients. According to researchers, pharmacologic therapy was predominant in two institutions, while radiation was prominent at the third.
“Therapeutic outcomes were similar to those reported in the European registries,” Portocarrero-Ortiz and colleagues wrote. – by Andy Polhamus
Disclosure: Moises Mercado reports being a consultant and lecturer for Novartis Oncology and Ipsen Pharmaceuticals. No other authors report any relevant financial disclosures.