A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities

From Giustina et al (16).

Abbreviations: BMD, bone mineral density; DXA, dual-energy x-ray absorptiometry; OGTT, oral glucose tolerance test; OSA, obstructive sleep apnea; PRL, prolactin; SHBG, sex hormone binding globulin; SRL, somatostatin receptor ligand.

Authors and Disclosures

Andrea Giustina¹, Ariel Barkan², Albert Beckers³, Nienke Biermasz⁴, Beverly M. K. Biller⁵, Cesar Boguszewski⁶, Marek Bolanowski⁷, Vivien Bonert⁸, Marcello D. Bronstein⁹, Felipe F. Casanueva¹⁰, David Clemmons¹¹, Annamaria Colao¹², Diego Ferone¹³, Maria Fleseriu¹⁴, Stefano Frara¹, Monica R. Gadelha¹⁵, Ezio Ghigo¹⁶, Mark Gurnell¹⁷, Anthony P. Heaney¹⁸, Ken Ho¹⁹, Adriana Ioachimescu²⁰, Laurence Katznelson²¹, Fahrettin Kelestimur²², John Kopchick²³, Michal Krsek²⁴, Steven Lamberts²⁵, Marco Losa²⁶, Anton Luger²⁷, Pietro Maffei²⁸, Monica Marazuela²⁹, Gherardo Mazziotti³⁰, Moises Mercado³¹, Pietro Mortini²⁶, Sebastian Neggers³², Alberto M. Pereira⁴, Stephan Petersenn³³, Manel Puig-Domingo³⁴, Roberto Salvatori³⁵, Ilan Shimon³⁶, Christian Strasburger³⁷, Stylianos Tsagarakis³⁸, A. J. van der Lely³², John Wass³⁹, Maria Chiara Zatelli⁴⁰ and Shlomo Melmed<sup>8

1</sup>Division of Endocrinology and Metabolism, San Raffaele University Hospital, Milan, Italy; ²Division of Endocrinology, University of Michigan Health System, Ann Arbor, Michigan; ³Department of Endocrinology, University of Liège, Liège, Belgium; ⁴Division of Endocrinology and Center for Endocrine Tumors, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands; ⁵Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; ⁶SEMPR, Endocrine Division, Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil; ⁷Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland; ⁸Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California; ⁹Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo, Sao Paulo, Brazil; ¹⁰Division of Endocrinology, Santiago de Compostela University and Ciber OBN, Santiago de Compostela, Spain; ¹¹Department of Medicine, University of North Carolina, Chapel Hill, North Carolina; ¹²Division of Endocrinologia, Universita' Federico II di Napoli, Naples, Italy; ¹³Endocrinology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy; ¹⁴Departments of Medicine and Neurological Surgery, Pituitary Center, Oregon Health & Science University, Portland, Oregon; ¹⁵Neuroendocrinology Research Center/Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; ¹⁶Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy; ¹⁷University of Cambridge & Addenbrooke's Hospital, Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Cambridge, United Kingdom; ¹⁸Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California; ¹⁹The Garvan Institute of Medical Research and St. Vincent's Hospital, Sydney, Australia; ²⁰Department of Medicine, Division of Endocrinology, Metabolism and Lipids, and Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia; ²¹Departments of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, California; ²²Yeditepe University, Faculty of Medicine, Istanbul, Turkey; ²³Edison Biotechnology Institute and Department of Biomedical Sciences, Ohio University, Athens, Ohio; ²⁴2nd Department of Medicine, 3rd Faculty of Medicine of the Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic; ²⁵Erasmus Medical Center, Rotterdam, The Netherlands; ²⁶Department of Neurosurgery, San Raffaele University Health Institute Milan, Milan, Italy; ²⁷Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria; ²⁸Department of Medicine, Padua University Hospital, Padua, Italy; ²⁹Department of Medicine, CIBERER, Universidad Autónoma de Madrid, Madrid, Spain; ³⁰Endocrinology Unit, Humanitas University and Humanitas Clinical and Research Center, Rozzano, Milan, Italy; ³¹Division of Medicine, National Autonomous University of Mexico, Experimental Endocrinology Unit, Centro Médico Nacional, Siglo XXI, IMSS, Mexico City, Mexico; ³²Pituitary Center Rotterdam, Endocrinology Section, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; ³³ENDOC Center for Endocrine Tumors, Hamburg, Germany; ³⁴Endocrinology Service, CIBER and CIBERES Germans Trias i Pujol Research Institute and Hospital, Autonomous University of Barcelona, Badalona, Spain; ³⁵Division of Endocrinology, Diabetes, and Metabolism and Pituitary Center, Johns Hopkins School of Medicine, Baltimore, Maryland; ³⁶Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel; ³⁷Department of Medicine for Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin, Berlin, Germany; ³⁸Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece; ³⁹Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom; and ⁴⁰Section of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

Correspondence and Reprint Requests
Shlomo Melmed, MD, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Room 2015, Los Angeles, CA, 90048.

Author Contributions
A.G. and S.M. served as Program Coordinators of the 12th Acromegaly Consensus Conference. N.B., M.D.B., F.E.C., D.C., M.F., C.S., P.M., J.W., and A.V.D.L. served as Steering Committee Members. All authors researched data for the Conference. A.G. and S.M. wrote the initial manuscript and all authors reviewed and/or edited the manuscript before submission.

Disclosure Summary
B.M.K.B., M.B., M.D.B., V.B., D.C., M.F., A.G., A.I., A.L., M.M., S.N., S.P., C.S., I.S., R.S., and A.V.D.L. have received consulting fees from Pfizer. B.M.K.B., D.F., M.F., A.G., M.R.G., A.P..H, A.L., M.L., G.M., M.M., S.M., S.P., C.S., I.S., and M.C.Z. have received consulting fees from Novartis. D.C., D.F., M.F., A.G., A.L., M.L., G.M., S.N., S.P., and C.S. have received consulting fees from Ipsen. D.C., M.F., A.G., L.K., S.M., and C.S. have received consulting fees from Chiasma. D.C. and S.N. have received consulting fees from Crinetics. M.F. and S.M. have received consulting fees from Ionis and Ono. M.G. has received consulting fees from AstraZeneca. D.F. has received consulting fees from Bristol-Myers Squibb. M.L. has received consulting fees from Eli Lilly. S.M. has received consulting fees from Midatech. A.P.H. and R.S. have received consulting fees from Novo Nordisk. M.C.Z. has received consulting fees from Sanofi. A.P.H. has received consulting fees from Strongbridge. A.B., B.M.K.B., M.B., M.D.B., D.F., M.F., M.R.G., A.I., L.K., and R.S. have received fees for contracted research from Novartis. M.B., M.D.B., F.F.C., D.F., M.F., M.R.G., and R.S. have received fees for contracted research from Ipsen. F.F.C., M.F., A.I., P.M., S.M., and R.S. have received fees for contracted research from Pfizer. M.B., M.F., A.I., and M.P.D. have received fees for contracted research from Chiasma. M.B., K.H., and R.S. have received fees for contracted research from Novo Nordisk. M.B. and R.S. have received fees for contracted research from Strongbridge. M.B. has received fees for contracted research from HRA Pharma. M.F. has received fees for contracted research from Ionis and Ono. R.S. has received fees for contracted research from Opko Biologics. K.H. has received fees for contracted research from Versartis. C.B., M.B., M.D.B., M.G., K.H., A.L., M.M., and M.P.D. have served as members of the speakers bureau for Ipsen. C.B., M.B., M.D.B., M.G., K.H., A.L., M.M., and M.P.D. have served as members of the speakers bureau for Novartis. C.B., M.B., F.F.C., M.G., and A.L. have served as members of the speakers bureau for Pfizer. M.K. has received lecture fees from Merck, Eli Lilly, and Shire. M.R.G. has received lecture fees from Novartis. A.V.D.L. has an ownership interest in Millendo Therapeutics. A.B., N.B., A.C., S.F., E.G., F.K., J.K., S.L., P.M., A.P., S.T., and J.W. have nothing to declare.