Consensus on acromegaly therapeutic outcomes: an update

Shlomo Melmed; Luigi di Filippo; Maria Fleseriu; Moisés Mercado; Niki Karavitaki; Mark Gurnell; Roberto Salvatori; Stylianos Tsagarakis; Marco Losa; Pietro Maffei; Alberto M. Pereira; Eliza B. Geer; Laurence Katznelson; Aart Jan van der Lely; Jens Bollerslev; Daniela Esposito; Susan M. Webb; Maria Chiara Zatelli; Elena Valassi; Sebastian Neggers; Philippe Chanson; Ken K.Y. Ho; Adriana G. Ioachimescu; Beverly M.K. Biller; Susan L. Samson; Ursula B. Kaiser; Katharina Schilbach; Raúl M. Luque; Felipe F. Casanueva; Ilan Shimon; Cesar L. Boguszewski; Nienke Biermasz; Annamaria Colao; Rosa Pirchio; Steven W.J. Lamberts; Pinar Kadioglu; Michael Buchfelder; Stefano Frara; Sabrina Chiloiro; Stephan Petersenn; Monica R. Gadelha; Manel Puig-Domingo; Anton Luger; Thierry Brue; Albert Beckers; Diego Ferone; David R. Clemmons; Yona Greenman; Mónica Marazuela; Pietro Mortini; Christian J. Strasburger; Andrea Giustina

doi:10.1038/s41574-025-01148-2

Consensus on acromegaly therapeutic outcomes: an update

Shlomo Melmed, Luigi di Filippo, Maria Fleseriu, Moisés Mercado, Niki Karavitaki, Mark Gurnell, Roberto Salvatori, Stylianos Tsagarakis, Marco Losa, Pietro Maffei, Alberto M. Pereira, Eliza B. Geer, Laurence Katznelson, Aart Jan van der Lely, Jens Bollerslev, Daniela Esposito, Susan M. Webb, Maria Chiara Zatelli, Elena Valassi, Sebastian NeggersPhilippe Chanson, Ken K.Y. Ho, Adriana G. Ioachimescu, Beverly M.K. Biller, Susan L. Samson, Ursula B. Kaiser, Katharina Schilbach, Raúl M. Luque, Felipe F. Casanueva, Ilan Shimon, Cesar L. Boguszewski, Nienke Biermasz, Annamaria Colao, Rosa Pirchio, Steven W.J. Lamberts, Pinar Kadioglu, Michael Buchfelder, Stefano Frara, Sabrina Chiloiro, Stephan Petersenn, Monica R. Gadelha, Manel Puig-Domingo, Anton Luger, Thierry Brue, Albert Beckers, Diego Ferone, David R. Clemmons, Yona Greenman, Mónica Marazuela, Pietro Mortini, Christian J. Strasburger, Andrea Giustina^*

^*Corresponding author for this work

Internal Medicine

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	718-737
Number of pages	20
Journal	Nature Reviews Endocrinology
Volume	21
Issue number	11
DOIs	https://doi.org/10.1038/s41574-025-01148-2
Publication status	Published - Nov 2025

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Publisher Copyright:
© Springer Nature Limited 2025.

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Melmed, S., di Filippo, L., Fleseriu, M., Mercado, M., Karavitaki, N., Gurnell, M., Salvatori, R., Tsagarakis, S., Losa, M., Maffei, P., Pereira, A. M., Geer, E. B., Katznelson, L., van der Lely, A. J., Bollerslev, J., Esposito, D., Webb, S. M., Zatelli, M. C., Valassi, E., ... Giustina, A. (2025). Consensus on acromegaly therapeutic outcomes: an update. Nature Reviews Endocrinology, 21(11), 718-737. https://doi.org/10.1038/s41574-025-01148-2

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title = "Consensus on acromegaly therapeutic outcomes: an update",

abstract = "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.",

author = "Shlomo Melmed and \{di Filippo\}, Luigi and Maria Fleseriu and Mois{\'e}s Mercado and Niki Karavitaki and Mark Gurnell and Roberto Salvatori and Stylianos Tsagarakis and Marco Losa and Pietro Maffei and Pereira, \{Alberto M.\} and Geer, \{Eliza B.\} and Laurence Katznelson and \{van der Lely\}, \{Aart Jan\} and Jens Bollerslev and Daniela Esposito and Webb, \{Susan M.\} and Zatelli, \{Maria Chiara\} and Elena Valassi and Sebastian Neggers and Philippe Chanson and Ho, \{Ken K.Y.\} and Ioachimescu, \{Adriana G.\} and Biller, \{Beverly M.K.\} and Samson, \{Susan L.\} and Kaiser, \{Ursula B.\} and Katharina Schilbach and Luque, \{Ra{\'u}l M.\} and Casanueva, \{Felipe F.\} and Ilan Shimon and Boguszewski, \{Cesar L.\} and Nienke Biermasz and Annamaria Colao and Rosa Pirchio and Lamberts, \{Steven W.J.\} and Pinar Kadioglu and Michael Buchfelder and Stefano Frara and Sabrina Chiloiro and Stephan Petersenn and Gadelha, \{Monica R.\} and Manel Puig-Domingo and Anton Luger and Thierry Brue and Albert Beckers and Diego Ferone and Clemmons, \{David R.\} and Yona Greenman and M{\'o}nica Marazuela and Pietro Mortini and Strasburger, \{Christian J.\} and Andrea Giustina",

note = "Publisher Copyright: {\textcopyright} Springer Nature Limited 2025.",

year = "2025",

month = nov,

doi = "10.1038/s41574-025-01148-2",

language = "English",

volume = "21",

pages = "718--737",

journal = "Nature Reviews Endocrinology",

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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 2025, 'Consensus on acromegaly therapeutic outcomes: an update', Nature Reviews Endocrinology, vol. 21, no. 11, pp. 718-737. https://doi.org/10.1038/s41574-025-01148-2

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T2 - an update

AU - Melmed, Shlomo

AU - di Filippo, Luigi

AU - Fleseriu, Maria

AU - Mercado, Moisés

AU - Karavitaki, Niki

AU - Gurnell, Mark

AU - Salvatori, Roberto

AU - Tsagarakis, Stylianos

AU - Losa, Marco

AU - Maffei, Pietro

AU - Pereira, Alberto M.

AU - Geer, Eliza B.

AU - Katznelson, Laurence

AU - van der Lely, Aart Jan

AU - Bollerslev, Jens

AU - Esposito, Daniela

AU - Webb, Susan M.

AU - Zatelli, Maria Chiara

AU - Valassi, Elena

AU - Neggers, Sebastian

AU - Chanson, Philippe

AU - Ho, Ken K.Y.

AU - Ioachimescu, Adriana G.

AU - Biller, Beverly M.K.

AU - Samson, Susan L.

AU - Kaiser, Ursula B.

AU - Schilbach, Katharina

AU - Luque, Raúl M.

AU - Casanueva, Felipe F.

AU - Shimon, Ilan

AU - Boguszewski, Cesar L.

AU - Biermasz, Nienke

AU - Colao, Annamaria

AU - Pirchio, Rosa

AU - Lamberts, Steven W.J.

AU - Kadioglu, Pinar

AU - Buchfelder, Michael

AU - Frara, Stefano

AU - Chiloiro, Sabrina

AU - Petersenn, Stephan

AU - Gadelha, Monica R.

AU - Puig-Domingo, Manel

AU - Luger, Anton

AU - Brue, Thierry

AU - Beckers, Albert

AU - Ferone, Diego

AU - Clemmons, David R.

AU - Greenman, Yona

AU - Marazuela, Mónica

AU - Mortini, Pietro

AU - Strasburger, Christian J.

AU - Giustina, Andrea

PY - 2025/11

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AB - 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.

UR - https://www.scopus.com/pages/publications/105013227948

U2 - 10.1038/s41574-025-01148-2

DO - 10.1038/s41574-025-01148-2

M3 - Article

C2 - 40804505

AN - SCOPUS:105013227948

SN - 1759-5029

VL - 21

SP - 718

EP - 737

JO - Nature Reviews Endocrinology

JF - Nature Reviews Endocrinology

IS - 11

ER -

Consensus on acromegaly therapeutic outcomes: an update

Abstract

Bibliographical note

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