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

      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 1 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 26 , 32 , 4 , 33 , 34 , 35 , 36 , 37 , 38 , 32 , 39 ,   40 , 8
      The Journal of Clinical Endocrinology & Metabolism
      The Endocrine Society

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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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          Author and article information

          Journal
          The Journal of Clinical Endocrinology & Metabolism
          The Endocrine Society
          0021-972X
          1945-7197
          October 13 2019
          Affiliations
          [1 ]Division of Endocrinology and Metabolism, San Raffaele University Hospital, Milan, Italy
          [2 ]Division of Endocrinology, University of Michigan Health System, Ann Arbor, Michigan, USA
          [3 ]Department of Endocrinology, University of Liège, Liège, Belgium
          [4 ]Division of Endocrinology and Center for Endocrine Tumors, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
          [5 ]Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
          [6 ]SEMPR, Endocrine Division, Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil
          [7 ]Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
          [8 ]Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
          [9 ]Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo, Sao Paulo, Brazil
          [10 ]Division of Endocrinology, Santiago de Compostela University and Ciber OBN, Santiago de Compostela, Spain
          [11 ]Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
          [12 ]Division of Endocrinologia, Universita’ Federico II di Napoli, Naples, Italy
          [13 ]Endocrinology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
          [14 ]Departments of Medicine and Neurological Surgery, Pituitary Center, Oregon Health & Science University, Portland, Oregon, USA
          [15 ]Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
          [16 ]Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy
          [17 ]University of Cambridge & Addenbrooke’s Hospital, Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Cambridge, United Kingdom
          [18 ]Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
          [19 ]The Garvan Institute of Medical Research and St. Vincent’s Hospital, Sydney, Australia
          [20 ]Department of Medicine, Division of Endocrinology, Metabolism and Lipids, and Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
          [21 ]Departments of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
          [22 ]Yeditepe University, Faculty of Medicine, Istanbul, Turkey
          [23 ]Edison Biotechnology Institute and Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA
          [24 ]2nd Department of Medicine, 3rd Faculty of Medicine of the Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
          [25 ]Erasmus Medical Center, Rotterdam, The Netherlands
          [26 ]Department of Neurosurgery, San Raffaele University Health Institute Milan, Milan, Italy
          [27 ]Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
          [28 ]Department of Medicine, Padua University Hospital, Padua, Italy
          [29 ]Department of Medicine, CIBERER, Universidad Autónoma de Madrid, Madrid, Spain
          [30 ]Endocrinology Unit, Humanitas University and Humanitas Clinical and Research Center, Rozzano, Milan, Italy
          [31 ]Division of Medicine, National Autonomous University of Mexico, Experimental Endocrinology Unit, Centro Médico Nacional, Siglo XXI, IMSS, Mexico City, Mexico
          [32 ]Pituitary Center Rotterdam, Endocrinology Section, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
          [33 ]ENDOC Center for Endocrine Tumors, Hamburg, Germany
          [34 ]Endocrinology Service, CIBER and CIBERES Germans Trias i Pujol Research Institute and Hospital, Autonomous University of Barcelona, Badalona, Spain
          [35 ]Division of Endocrinology, Diabetes, and Metabolism and Pituitary Center, Johns Hopkins School of Medicine, Baltimore, USA
          [36 ]Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
          [37 ]Department of Medicine for Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin, Berlin, Germany
          [38 ]Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece
          [39 ]Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom
          [40 ]Section of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
          Article
          10.1210/clinem/dgz096
          31606735
          a803cf77-98ef-4fe7-b8b0-5764f59a4f9b
          © 2019

          https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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