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The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 2 526-529
Copyright © 2000 by The Endocrine Society

Special Articles

Criteria for Cure of Acromegaly: A Consensus Statement1{dagger}

Andrea Giustina, Ariel Barkan, Felipe F. Casanueva, Franco Cavagnini, Lawrence Frohman, Ken Ho, Johannes Veldhuis, John Wass, Klaus von Werder and Shlomo Melmed

Department of Internal Medicine/Endocrine Section (A.G.), University of Brescia, Brescia, Italy; Veterans Affairs Medical Center (A.B.), Ann Arbor, Michigan; Endocrine Section, Department of Medicine, Santiago de Compostela University (F.F.C.), Spain; Division of Endocrinology and Metabolism, Ospedale San Luca, University of Milan (F.C.), Milan, Italy; Department of Medicine, University of Illinois at Chicago (L.F.), Chicago, Illinois; Department of Endocrinology, Garvan Institute of Medical Research, St. Vincents Hospital (K.H.), Sydney, Australia; Department of Medicine, Division of Endocrinology and Metabolism, University of Virginia School of Medicine (J.V.), Charlottesville, Virginia; Department of Endocrinology, Radcliffe Infirmary (J.W.), Oxford, United Kingdom; Department of Medicine, Schlosspark Klinik (K.v.W.), Berlin, Germany; and Cedars-Sinai Research Institute, University of California–Los Angeles School of Medicine (S.M.), Los Angeles, California 90048

Address correspondence and requests for reprints to: Shlomo Melmed, Cedars-Sinai Medical Center,8700 Beverly Boulevard, Room 2015, Los Angeles, California 90048. E-mail: melmed{at}csmc.edu

In February 1999, a workshop was held in Cortina, Italy to develop a consensus defining the criteria for cure of acromegaly. The workshop was sponsored by the University of Brescia and hosted by the Italian Society of Endocrinology. Invited international participants included endocrinologists, neurosurgeons, and radiotherapists skilled in the management of acromegaly. This statement summarizes the consensus achieved in these discussions.




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C. A. Hurty and B. Flatland
Feline Acromegaly: A Review of the Syndrome
J. Am. Anim. Hosp. Assoc., September 1, 2005; 41(5): 292 - 297.
[Abstract] [Full Text] [PDF]

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G M Besser, P Burman, and A F Daly
Predictors and rates of treatment-resistant tumor growth in acromegaly
Eur. J. Endocrinol., August 1, 2005; 153(2): 187 - 193.
[Abstract] [Full Text] [PDF]

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R. Fahlbusch, B. v Keller, O. Ganslandt, J. Kreutzer, and C. Nimsky
Transsphenoidal surgery in acromegaly investigated by intraoperative high-field magnetic resonance imaging
Eur. J. Endocrinol., August 1, 2005; 153(2): 239 - 248.
[Abstract] [Full Text] [PDF]

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A. P Silva, K. Bethmann, F. Raulf, and H. A Schmid
Regulation of ghrelin secretion by somatostatin analogs in rats
Eur. J. Endocrinol., June 1, 2005; 152(6): 887 - 894.
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S. V. Rowles, L. Prieto, X. Badia, S. M. Shalet, S. M. Webb, and P. J. Trainer
Quality of Life (QOL) in Patients with Acromegaly Is Severely Impaired: Use of a Novel Measure of QOL: Acromegaly Quality of Life Questionnaire
J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3337 - 3341.
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N. R. Biermasz, A. M. Pereira, J. W. A. Smit, J. A. Romijn, and F. Roelfsema
Morbidity after Long-Term Remission for Acromegaly: Persisting Joint-Related Complaints Cause Reduced Quality of Life
J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2731 - 2739.
[Abstract] [Full Text] [PDF]

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J. J. Puder, S. Nilavar, K. D. Post, and P. U. Freda
Relationship between Disease-Related Morbidity and Biochemical Markers of Activity in Patients with Acromegaly
J. Clin. Endocrinol. Metab., April 1, 2005; 90(4): 1972 - 1978.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. A. Sakharova, E. V. Dimaraki, W. F. Chandler, and A. L. Barkan
Clinically Silent Somatotropinomas May Be Biochemically Active
J. Clin. Endocrinol. Metab., April 1, 2005; 90(4): 2117 - 2121.
[Abstract] [Full Text] [PDF]

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 Eur J EndocrinolHome page
P. Nomikos, M. Buchfelder, and R. Fahlbusch
The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical 'cure'
Eur. J. Endocrinol., March 1, 2005; 152(3): 379 - 387.
[Abstract] [Full Text] [PDF]

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C. L. Ronchi, V. Varca, C. Giavoli, P. Epaminonda, P. Beck-Peccoz, A. Spada, and M. Arosio
Long-Term Evaluation of Postoperative Acromegalic Patients in Remission with Previous and Newly Proposed Criteria
J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1377 - 1382.
[Abstract] [Full Text] [PDF]

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M. Terzolo, G. Reimondo, M. Gasperi, R. Cozzi, R. Pivonello, G. Vitale, A. Scillitani, R. Attanasio, E. Cecconi, F. Daffara, et al.
Colonoscopic Screening and Follow-Up in Patients with Acromegaly: A Multicenter Study in Italy
J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 84 - 90.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
H. Bihan, C. Espinosa, H. Valdes-Socin, S. Salenave, J. Young, S. Levasseur, P. Assayag, A. Beckers, and P. Chanson
Long-Term Outcome of Patients with Acromegaly and Congestive Heart Failure
J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5308 - 5313.
[Abstract] [Full Text] [PDF]

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E. J. M. Zirkzee, E. P. M. Corssmit, N. R. Biermasz, P. A. Brouwer, F. T. Wiggers-De Bruine, L. J. M. Kroft, M. A. Van Buchem, F. Roelfsema, A. M. Pereira, J. W. A. Smit, et al.
Pituitary Magnetic Resonance Imaging Is Not Required in the Postoperative Follow-Up of Acromegalic Patients with Long-Term Biochemical Cure after Transsphenoidal Surgery
J. Clin. Endocrinol. Metab., September 1, 2004; 89(9): 4320 - 4324.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
J. Ayuk, R. N. Clayton, G. Holder, M. C. Sheppard, P. M. Stewart, and A. S. Bates
Growth Hormone and Pituitary Radiotherapy, But Not Serum Insulin-Like Growth Factor-I Concentrations, Predict Excess Mortality in Patients with Acromegaly
J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1613 - 1617.
[Abstract] [Full Text] [PDF]

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 Clin. Chem.Home page
C. Schmid, P. Wiesli, R. Bernays, K. Bloch, J. Zapf, C. Zwimpfer, C. Ghirlanda, and M. Brandle
Decrease in sE-Selectin after Pituitary Surgery in Patients with Acromegaly
Clin. Chem., March 1, 2004; 50(3): 650 - 652.
[Full Text] [PDF]

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 HypertensionHome page
D. Rizzoni, E. Porteri, A. Giustina, C. De Ciuceis, I. Sleiman, G. E. M. Boari, M. Castellano, M. L. Muiesan, S. Bonadonna, A. Burattin, et al.
Acromegalic Patients Show the Presence of Hypertrophic Remodeling of Subcutaneous Small Resistance Arteries
Hypertension, March 1, 2004; 43(3): 561 - 565.
[Abstract] [Full Text] [PDF]

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 Endocr. Rev.Home page
A. Colao, D. Ferone, P. Marzullo, and G. Lombardi
Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management
Endocr. Rev., February 1, 2004; 25(1): 102 - 152.
[Abstract] [Full Text] [PDF]

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O. Serri, C. Beauregard, and J. Hardy
Long-Term Biochemical Status and Disease-Related Morbidity in 53 Postoperative Patients with Acromegaly
J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 658 - 661.
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A. Mukherjee, J. P. Monson, P. J. Jonsson, P. J. Trainer, and S. M. Shalet
Seeking the Optimal Target Range for Insulin-Like Growth Factor I during the Treatment of Adult Growth Hormone Disorders
J. Clin. Endocrinol. Metab., December 1, 2003; 88(12): 5865 - 5870.
[Abstract] [Full Text] [PDF]

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R. Attanasio, R. Baldelli, R. Pivonello, S. Grottoli, L. Bocca, V. Gasco, M. Giusti, G. Tamburrano, A. Colao, and R. Cozzi
Lanreotide 60 mg, a New Long-Acting Formulation: Effectiveness in the Chronic Treatment of Acromegaly
J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5258 - 5265.
[Abstract] [Full Text] [PDF]

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L. Spinelli, M. Petretta, G. Verderame, G. Carbone, A. A. Venetucci, A. Petretta, W. Acampa, D. Bonaduce, A. Colao, and A. Cuocolo
Left Ventricular Diastolic Function and Cardiac Performance during Exercise in Patients with Acromegaly
J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4105 - 4109.
[Abstract] [Full Text] [PDF]

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P. De, D. A. Rees, N. Davies, R. John, J. Neal, R. G. Mills, J. Vafidis, J. S. Davies, and M. F. Scanlon
Transsphenoidal Surgery for Acromegaly in Wales: Results Based on Stringent Criteria of Remission
J. Clin. Endocrinol. Metab., August 1, 2003; 88(8): 3567 - 3572.
[Abstract] [Full Text] [PDF]

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R. Cozzi, R. Attanasio, M. Montini, G. Pagani, G. Lasio, S. Lodrini, M. Barausse, M. Albizzi, D. Dallabonzana, and A. M. Pedroncelli
Four-Year Treatment with Octreotide-Long-Acting Repeatable in 110 Acromegalic Patients: Predictive Value of Short-Term Results?
J. Clin. Endocrinol. Metab., July 1, 2003; 88(7): 3090 - 3098.
[Abstract] [Full Text] [PDF]

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R. Attanasio, P. Epaminonda, E. Motti, E. Giugni, L. Ventrella, R. Cozzi, M. Farabola, P. Loli, P. Beck-Peccoz, and M. Arosio
Gamma-Knife Radiosurgery in Acromegaly: A 4-Year Follow-Up Study
J. Clin. Endocrinol. Metab., July 1, 2003; 88(7): 3105 - 3112.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. Colao, L. Spinelli, P. Marzullo, R. Pivonello, M. Petretta, C. Di Somma, G. Vitale, D. Bonaduce, and G. Lombardi
High Prevalence of Cardiac Valve Disease in Acromegaly: An Observational, Analytical, Case-Control Study
J. Clin. Endocrinol. Metab., July 1, 2003; 88(7): 3196 - 3201.
[Abstract] [Full Text] [PDF]

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R. N. Clayton
Cardiovascular Function in Acromegaly
Endocr. Rev., June 1, 2003; 24(3): 272 - 277.
[Abstract] [Full Text] [PDF]

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A. Giustina and S. Melmed
Acromegaly Consensus: The Next Steps
J. Clin. Endocrinol. Metab., April 1, 2003; 88(4): 1913 - 1914.
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Z Merza
Modern treatment of acromegaly
Postgrad. Med. J., April 1, 2003; 79(930): 189 - 194.
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J. J. Kopchick, C. Parkinson, E. C. Stevens, and P. J. Trainer
Growth Hormone Receptor Antagonists: Discovery, Development, and Use in Patients with Acromegaly
Endocr. Rev., October 1, 2002; 23(5): 623 - 646.
[Abstract] [Full Text] [PDF]

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 EndocrinologyHome page
G. Weckbecker, U. Briner, I. Lewis, and C. Bruns
SOM230: A New Somatostatin Peptidomimetic with Potent Inhibitory Effects on the Growth Hormone/Insulin-Like Growth Factor-I Axis in Rats, Primates, and Dogs
Endocrinology, October 1, 2002; 143(10): 4123 - 4130.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
J. Ayuk, S. E. Stewart, P. M. Stewart, and M. C. Sheppard
Long-Term Safety and Efficacy of Depot Long-Acting Somatostatin Analogs for the Treatment of Acromegaly
J. Clin. Endocrinol. Metab., September 1, 2002; 87(9): 4142 - 4146.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. Colao, M. De Rosa, R. Pivonello, A. Balestrieri, P. Cappabianca, A. Di Sarno, V. Rochira, C. Carani, and G. Lombardi
Short-Term Suppression of GH and IGF-I Levels Improves Gonadal Function and Sperm Parameters in Men with Acromegaly
J. Clin. Endocrinol. Metab., September 1, 2002; 87(9): 4193 - 4197.
[Abstract] [Full Text] [PDF]

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 J ANIM SCIHome page
N. R. Adams, J. R. Briegel, and K. A. Ward
The impact of a transgene for ovine growth hormone on the performance of two breeds of sheep
J Anim Sci, September 1, 2002; 80(9): 2325 - 2333.
[Abstract] [Full Text] [PDF]

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P. J. Trainer
Acromegaly--Consensus, What Consensus?
J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3534 - 3536.
[Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
E. V. Dimaraki, C. A. Jaffe, R. DeMott-Friberg, W. F. Chandler, and A. L. Barkan
Acromegaly with Apparently Normal GH Secretion: Implications for Diagnosis and Follow-Up
J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3537 - 3542.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
P. U. Freda
Somatostatin Analogs in Acromegaly
J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3013 - 3018.
[Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. Colao, L. Spinelli, A. Cuocolo, S. Spiezia, R. Pivonello, C. di Somma, D. Bonaduce, M. Salvatore, and G. Lombardi
Cardiovascular Consequences of Early-Onset Growth Hormone Excess
J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3097 - 3104.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. C. F. Costa, A. Rossi, C. E. Martinelli Jr., H. R. Machado, and A. C. Moreira
Assessment of Disease Activity in Treated Acromegalic Patients Using a Sensitive GH Assay: Should We Achieve Strict Normal GH Levels for a Biochemical Cure?
J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3142 - 3147.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
C. Parkinson, W. M. Drake, M. E. Roberts, K. Meeran, G. M. Besser, and P. J. Trainer
A Comparison of the Effects of Pegvisomant and Octreotide on Glucose, Insulin, Gastrin, Cholecystokinin, and Pancreatic Polypeptide Responses to Oral Glucose and a Standard Mixed Meal
J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1797 - 1804.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
Ph. Caron, A. Beckers, D. R. Cullen, M. I. Goth, B. Gutt, P. Laurberg, A. M. Pico, M. Valimaki, and W. Zgliczynski
Efficacy of the New Long-Acting Formulation of Lanreotide (Lanreotide Autogel) in the Management of Acromegaly
J. Clin. Endocrinol. Metab., January 1, 2002; 87(1): 99 - 104.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
C. Parkinson, W. D. J. Ryder, and P. J. Trainer
The Relationship between Serum GH and Serum IGF-I in Acromegaly Is Gender-Specific
J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5240 - 5244.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
M. Andersen, C. H. Jensen, R. K. Stoving, J. B. Larsen, H. D. Schroder, B. Teisner, and C. Hagen
Fetal Antigen 1 in Healthy Adults and Patients with Pituitary Disease: Relation to Physiological, Pathological, and Pharmacological GH Levels
J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5465 - 5470.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
J. Kreutzer, M. L. Vance, M. B. S. Lopes, and E. R. Laws Jr.
Surgical Management of GH-Secreting Pituitary Adenomas: An Outcome Study Using Modern Remission Criteria
J. Clin. Endocrinol. Metab., September 1, 2001; 86(9): 4072 - 4077.
[Abstract] [Full Text] [PDF]


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