%0 Journal Article
%T Acromegaly management in the Nordic countries: A Delphi consensus survey.
%A Arlien-Søborg MC
%A Dal J
%A Heck A
%A Stochholm K
%A Husted E
%A Feltoft CL
%A Rasmussen ÅK
%A Feldt-Rasmussen U
%A Andreassen M
%A Klose MC
%A Nielsen TL
%A Andersen MS
%A Christensen LL
%A Krogh J
%A Jarlov A
%A Bollerslev J
%A Nermoen I
%A Oksnes M
%A Dahlqvist P
%A Olsson T
%A Berinder K
%A Hoybye C
%A Petersson M
%A Akerman AK
%A Wahlberg J
%A Ekman B
%A Engstrom BE
%A Johannsson G
%A Ragnarsson O
%A Olsson D
%A Sigurjónsdóttir HÁ
%A Fougner SL
%A Matikainen N
%A Vehkavaara S
%A Metso S
%A Jaatinen P
%A Hämäläinen P
%A Rintamäki R
%A Yliaska I
%A Immonen H
%A Mäkimattila S
%A Cederberg-Tamminen H
%A Viukari M
%A Nevalainen P
%A Nuutila P
%A Schalin-Jäntti C
%A Burman P
%A Jørgensen JOL
%J Clin Endocrinol (Oxf)
%V 0
%N 0
%D 2024 Jun 12
%M 38865284
%F 3.523
%R 10.1111/cen.15095
%X <B>OBJECTIVE: </B>Acromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.<BR><B>METHODS: </B>A Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1-7). Consensus was defined as ≥80% of panelists rating their agreement as ≥5 or ≤3 on the Likert-type scale.<BR><B>RESULTS: </B>Consensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.<BR><B>CONCLUSIONS: </B>This consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.