A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update

Andrea Giustina(San Raffaele University of Rome), Ariel Barkan(Michigan Medicine), Albert Beckers(University of Liège), Nienke R. Biermasz(Leiden University Medical Center), Beverly M. K. Biller(Harvard University), César Luiz Boguszewski(Universidade Federal do Paraná), Marek Bolanowski(Wroclaw Medical University), Vivien Bonert(Cedars-Sinai Medical Center), Marcello D. Bronstein(Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo), Felipe F. Casanueva(Universidade de Santiago de Compostela), David R. Clemmons(University of North Carolina at Chapel Hill), Annamaria Colao(University of Naples Federico II), Diego Ferone(University of Genoa), Maria Fleseriu(Oregon Health & Science University), Stefano Frara(San Raffaele University of Rome), Mônica R. Gadelha(Universidade Federal do Rio de Janeiro), Ezio Ghigo(University of Turin), Mark Gurnell(University of Cambridge), Anthony P. Heaney(University of California, Los Angeles), Ken K. Y. Ho(Garvan Institute of Medical Research), Adriana G. Ioachimescu(Emory University), Laurence Katznelson(Stanford University), Fahrettin Keleştimur(Yeditepe University), John J. Kopchick(Biotechnology Institute), Michal Kršek(Charles University), Steven W. J. Lamberts(Erasmus MC), Marco Losa(San Raffaele University of Rome), Anton Luger(Medical University of Vienna), Pietro Maffei(University of Padua), Mónica Marazuela(Universidad Autónoma de Madrid), Gherardo Mazziotti(Humanitas University), Moisés Mercado(Centro Medico Nacional Siglo XXI), Pietro Mortini(San Raffaele University of Rome), Sebastian Neggers(Erasmus MC), Alberto M. Pereira(Leiden University Medical Center), Stephan Petersenn, Manel Puig‐Domingo(Universitat Autònoma de Barcelona), Roberto Salvatori(Johns Hopkins University), Ilan Shimon(Rabin Medical Center), Christian J. Strasburger(Charité - Universitätsmedizin Berlin), Stylianos Tsagarakis(Evangelismos Hospital), A. J. van der Lely(Erasmus MC), John Wass(Churchill Hospital), Maria Chiara Zatelli(University of Ferrara), Шломо Мелмед(Cedars-Sinai Medical Center)
The Journal of Clinical Endocrinology & Metabolism
October 13, 2019
10.1210/clinem/dgz096
Cited by 357Open Access
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Abstract

OBJECTIVE: The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013. PARTICIPANTS: The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration. EVIDENCE: This evidence-based consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities. CONSENSUS PROCESS: Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system. CONCLUSIONS: Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality.

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