Full Guideline: Acromegaly: An Endocrine Society Clinical Practice Guideline
JCEM November 2014

Laurence Katznelson, Edward R. Laws, Jr, Shlomo Melmed, Mark E. Molitch, Mohammad Hassan Murad, Andrea Utz, John A. H. Wass


The aim was to formulate clinical practice guidelines for acromegaly.


Acromegaly is a chronic disorder caused by GH hypersecretion. GH circulates and stimulates production of IGF-1 from the liver and systemic tissues; IGF-1 in large part mediates the somatic and metabolic effects of GH. Hypersecretion of GH leads to excess production of IGF-1, leading to a multisystem disease characterized by somatic overgrowth, multiple comorbidities, premature mortality, and physical disfigurement. A multidisciplinary approach is critical for the management of acromegaly.

Using an evidence-based approach, this acromegaly guideline addresses important clinical issues regarding the evaluation and management of acromegaly, including:

  • the appropriate biochemical assessment,
  • a therapeutic algorithm, including use of medical monotherapy or combination therapy,
  • and management during pregnancy.

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