A Pituitary Society update to acromegaly management guidelines
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A Pituitary Society update to acromegaly management guidelines Maria Fleseriu1 · Beverly M. K. Biller2 · Pamela U. Freda3 · Monica R. Gadelha4 · Andrea Giustina5 · Laurence Katznelson6 · Mark E. Molitch7 · Susan L. Samson8 · Christian J. Strasburger9 · A. J. van der Lely10 · Shlomo Melmed11 Accepted: 28 September 2020 © The Author(s) 2020
Abstract Guidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of Endocrine Society guidelines and Acromegaly Consensus Group statements. This update focuses on how recent key advances affect treatment decision-making and outcomes, and also highlights the likely role of recently FDA-approved therapies as well as novel combination therapies within the treatment armamentarium. Keywords Pituitary adenoma · Acromegaly · Growth hormone · Insulin-like growth factor I · Somatostatin receptor ligand · Pegvisomant · Oral octreotide
Introduction Guidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of Endocrine
* Shlomo Melmed [email protected] 1
Pituitary Center, Departments of Medicine and Neurological Surgery, Oregon Health & Science University, Portland, OR, USA
2
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
3
Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
4
Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
5
Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS San Raffaele Hospital, Milan, Italy
Society guidelines [1] and Acromegaly Consensus Group statements [2, 3]. This update focuses on how recent key advances affect treatment decision-making and outcomes, and also highlights the likely role of recently FDA-approved therapies as well as novel combination therapies within the treatment armamentarium. Key summary points are presented in Tables 1, 2, 3. Grading of evidence and recommendations are described in Table 4.
6
Departments of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
7
Division of Endocrinology, Metabolism & Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
8
Pituitary Center, Departments of Medicine and
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