Multidisciplinary management of acromegaly: A consensus

Abstract

The 13th Acromegaly Consensus Conference was held in November 2019 in Fort Lauderdale, Florida, and comprised acromegaly experts including endocrinologists and neurosurgeons who considered optimal approaches for multidisciplinary acromegaly management. Focused discussions reviewed techniques, results, and side effects of surgery, radiotherapy, and medical therapy, and how advances in technology and novel techniques have changed the way these modalities are used alone or in combination. Effects of treatment on patient outcomes were considered, along with strategies for optimizing and personalizing therapeutic approaches. Expert consensus recommendations emphasize how best to implement available treatment options as part of a multidisciplinary approach at Pituitary Tumor Centers of Excellence.

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Funding

The 13th Acromegaly Consensus Conference was supported by unrestricted educational grants from Ipsen and Pfizer Inc. Scientific sponsorship of the meeting was provided by Cedars-Sinai Medical Center, Los Angeles, CA.

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Authors

Contributions

AG and SM served as Program Coordinators of the 13th Acromegaly Consensus Conference. MB, FC, DC, MF, PM, SS, CS, and JW served as Scientific Committee Members. All authors researched data for the Conference. AG and SM wrote the manuscript and all authors reviewed and/or edited the manuscript before submission.

Corresponding author

Correspondence to Andrea Giustina.

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Ethical approval

No original data from studies on patients are reported in this manuscript and therefore no ethical approval or informed consent was needed.

Conflicts of interest/competing interests

AG is consultant for Chiasma, Genevant, Ipsen, Pfizer and Recordati and received research grants from Ipsen, Novartis and Pfizer to his Institution.

AB has received research funding from Pfizer and travel and speaker grants from Novartis and Ipsen.

BMKB is PI of research support to Massachsuetts General Hospital from Crinetics, Ionis and Novartis, occasional consulting honoraria from Chiasma, Crinetics and Novartis.

CLB has served as consultant/speaker for Novartis and Ipsen.

MB has served as speaker for Novartis, Ipsen, Pfizer and Recordati.

VB has received research grants from Pfizer, and has served on advisory boards for Pfizer.

MDB is Member of Steering Committees and Advisory Boards of Chiasma, Ipsen, Novartis; Speaker for Ipsen, Novartis; and has received grants as PI for clinical trials from Crinetics, Ipsen, and Novartis.

PC has received unrestricted research and educational grants from Ipsen, Novartis, Crinetics and Pfizer on behalf of the Service of Endocrinology and Reproductive Diseases, Hôpitaux Universitaires Paris-Saclay and Association Recherche Endocrinologie Bicêtre, and has served as investigator (principal or coordinator) for clinical trials funded by Novartis, Pfizer, Ipsen, Italpharmaco, Chiasma. PC gave lectures for Ipsen, Novartis, and Pfizer. All the fees and honoraria are paid to his Institution or Research Association.

DC served as an advisory board member for Crinetics.

MF has received research support to OHSU as principal investigator from Chiasma, Crinetics, Ionis, Novartis and has received occasional scientific consulting from Chiasma, Crinetics, Ionis, Novartis, Pfizer.

PUF has received research grant to her institution for clinical research studies from Pfizer, Novartis, Ipsen and Chiasma.

MRG has been principal investigator in clinical trials from Novartis and Crinectics, has served on advisory boards for Novartis and Crinectics and served as apeaker for Novatis and Ipsen.

EBG is an investigator for research grants to MSKCC from Ionis, Novartis, Corcept, Strongbridge Biopharma, and Bristol-Myers Squibb. She has received a speaker’s fee for an educational presentaion for Chiasma.

APH has served as consultant/ speaker for Ipsen and Chiasma.

AGI has received institution-directed research grants from Chiasma, Strongbridge and Novartis and served as consultant for Tiburio.

PM received consultation or speaker fee, support for congress participation, and contribution to research projects from by Pfizer, Novartis, and Ipsen.

MEM received research support from Chiasma, Novartis, Ionis, and Crinetics.

SP has served as an advisory board member for Ipsen, Novartis, and Crinetics, and as speaker for Ipsen, Novartis, and Pfizer.

MPD has recived research grants from Pfizer and Novartis, has served on advisory boards for Pfizer, Novartis and Ipsen, and served as speaker for Novartis, Ipsen and Pfizer.

RS received support for educational activities at Johns Hopkins University from Pfizer and support clinical trials from Chiasma, Crinetics and Novartis.

SLS has served as an advisor and/or investigator for Novartis, Chiasma, Pfizer, and Ipsen, and has received investigator-initiated funding from Novartis.

IS has served as consultant and speaker for Novartis, Pfizer and Medison Pharma.

CS served as an advisor to and received speaker’s fees from Pfizer, Ipsen, Chiasma and Crinetics.

PT serves on advisory boards for Novartis, Crinetics, Chiasma and has received research funding to support clinical trials from Novartis, Crinetics, Chiasma, Strongbridge, Camarus. All honoraria and reseach income is administered by his institution.

MEW has received research grants to her institution for clinical research studies from Ionis and reviewed investigator-initiated research proposals for Pfizer.

KCJY has received research grants to his institution for clinical research studies from Ionis, Crinetics, and Novartis, and has served on advisory boards for Pfizer, and Ipsen.

MCZ received consulting fees from Novartis and Ipsen.

SM has received consulting fees from Chiasma, Crinetics, Ionis, Ipsen and research grants to the institution from Pfizer.

GB, ABS, NB, JB, MB, FC, AMF, MG, KKYH, SL, EL, ML, AM, MM, PM, MP, KP, BS, MLV, and JW have no conflict of interests to declare.

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Giustina, A., Barkhoudarian, G., Beckers, A. et al. Multidisciplinary management of acromegaly: A consensus. Rev Endocr Metab Disord 21, 667–678 (2020). https://doi.org/10.1007/s11154-020-09588-z

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Keywords

  • Acromegaly
  • Consensus
  • Multidisciplinary management
  • Medical therapy
  • Surgery
  • Radiotherapy
  • Pituitary tumor centers of excellence