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.

2nd Department of Medicine 3rd Faculty of Medicine of the Charles University and University Hospital Kralovske Vinohrady Prague Czech Republic

Department of Endocrinology Diabetes and Isotope Therapy Wroclaw Medical University Wroclaw Poland

Department of Endocrinology Diabetes and Metabolism Evangelismos Hospital Athens Greece

Department of Endocrinology Oxford Centre for Diabetes Endocrinology and Metabolism Churchill Hospital Oxford United Kingdom

Department of Endocrinology University of Liège Liège Belgium

Department of Medicine Cedars Sinai Medical Center Los Angeles California

Department of Medicine CIBERER Universidad Autónoma de Madrid Madrid Spain

Department of Medicine Division of Endocrinology Metabolism and Lipids and Department of Neurosurgery Emory University School of Medicine Atlanta Georgia

Department of Medicine for Endocrinology Diabetes and Nutritional Medicine Charité Universitätsmedizin Berlin Germany

Department of Medicine Padua University Hospital Padua Italy

Department of Medicine University of North Carolina Chapel Hill North Carolina

Department of Neurosurgery San Raffaele University Health Institute Milan Milan Italy

Departments of Medicine and Neurological Surgery Pituitary Center Oregon Health and Science University Portland Oregon

Departments of Medicine and Neurosurgery Stanford University School of Medicine Stanford California

Division of Endocrinologia Universita' Federico 2 di Napoli Naples Italy

Division of Endocrinology and Center for Endocrine Tumors Department of Medicine Leiden University Medical Center Leiden The Netherlands

Division of Endocrinology and Metabolism Department of Internal Medicine University of Turin Turin Italy

Division of Endocrinology and Metabolism Hospital das Clinicas University of Sao Paulo Sao Paulo Brazil

Division of Endocrinology and Metabolism Medical University of Vienna Vienna Austria

Division of Endocrinology and Metabolism San Raffaele University Hospital Milan Italy

Division of Endocrinology Diabetes and Hypertension Department of Medicine David Geffen School of Medicine University of California Los Angeles California

Division of Endocrinology Diabetes and Metabolism and Pituitary Center Johns Hopkins School of Medicine Baltimore Maryland

Division of Endocrinology Santiago de Compostela University and Ciber OBN Santiago de Compostela Spain

Division of Endocrinology University of Michigan Health System Ann Arbor Michigan

Division of Medicine National Autonomous University of Mexico Experimental Endocrinology Unit Centro Médico Nacional Siglo XXI IMSS Mexico City Mexico

Edison Biotechnology Institute and Department of Biomedical Sciences Ohio University Athens Ohio

ENDOC Center for Endocrine Tumors Hamburg Germany

Endocrine Institute Rabin Medical Center Beilinson Hospital Petah Tikva Israel

Endocrinology Service CIBER and CIBERES Germans Trias i Pujol Research Institute and Hospital Autonomous University of Barcelona Badalona Spain

Endocrinology Unit Department of Internal Medicine University of Genoa Genoa Italy

Endocrinology Unit Humanitas University and Humanitas Clinical and Research Center Rozzano Milan Italy

Erasmus Medical Center Rotterdam The Netherlands

Neuroendocrine Unit Massachusetts General Hospital Harvard Medical School Boston Massachusetts

Neuroendocrinology Research Center Endocrinology Section Medical School and Hospital Universitário Clementino Fraga Filho Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil

Pituitary Center Rotterdam Endocrinology Section Department of Internal Medicine Erasmus University Medical Center Rotterdam The Netherlands

Section of Endocrinology and Internal Medicine Department of Medical Sciences University of Ferrara Ferrara Italy

SEMPR Endocrine Division Department of Internal Medicine Federal University of Parana Curitiba Brazil

The Garvan Institute of Medical Research and St Vincent's Hospital Sydney Australia

University of Cambridge and Addenbrooke's Hospital Metabolic Research Laboratories Wellcome Trust MRC Institute of Metabolic Science Cambridge United Kingdom

Yeditepe University Faculty of Medicine Istanbul Turkey

J Clin Endocrinol Metab. 2020 Apr 1;105(4):dgz191. doi: 10.1210/clinem/dgz191. PubMed

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