Consensus on acromegaly therapeutic outcomes: an update

The 15th Acromegaly Consensus Conference in September 2023 updated recommendations on therapeutic outcomes for acromegaly. Since the publication of medical management guidelines in 2018, new pharmacological agents and new treatment approaches have been developed. Fifty-two experts in the management of acromegaly reviewed the current literature and assessed changes in drug approvals, clinical practice standards and management. Current outcome goals were considered, with a focus on the effect of current and emerging somatostatin receptor ligands, the growth hormone receptor antagonist pegvisomant and the dopamine agonist cabergoline on biochemical control, clinical control, adenoma mass and surgical outcomes. Participants assessed factors that determine pharmacological choices, as well as the proposed use of each agent. Here, we present consensus recommendations highlighting how an evidence-based acromegaly management algorithm could be optimized in clinical practice.

Citation

Melmed S, di Filippo L, Fleseriu M, Mercado M, Karavitaki N, Gurnell M, Salvatori R, Tsagarakis S, Losa M, Maffei P, Pereira AM, Geer EB, Katznelson L, van der Lely AJ, Bollerslev J, Esposito D, Webb SM, Zatelli MC, Valassi E, Neggers S, Chanson P, Ho KKY, Ioachimescu AG, Biller BMK, Samson SL, Kaiser UB, Schilbach K, Luque RM, Casanueva FF, Shimon I, Boguszewski CL, Biermasz N, Colao A, Pirchio R, Lamberts SWJ, Kadioglu P, Buchfelder M, Frara S, Chiloiro S, Petersenn S, Gadelha MR, Puig-Domingo M, Luger A, Brue T, Beckers A, Ferone D, Clemmons DR, Greenman Y, Marazuela M, Mortini P, Strasburger CJ, Giustina A. Consensus on acromegaly therapeutic outcomes: an update. Nat Rev Endocrinol. 2025 Nov;21(11):718-737. doi: 10.1038/s41574-025-01148-2. Epub 2025 Aug 13.

Type

Review