RT Journal Article
T1 Diagnosis, treatment and follow-up of patients with acromegaly in a clinical practice setting in Spain: the ACROPRAXIS program Delphi survey.
A1 de Pablos-Velasco, Pedro
A1 Venegas, Eva María
A1 Álvarez Escolá, Cristina
A1 Fajardo, Carmen
A1 de Miguel, Paz
A1 González, Natividad
A1 Bernabéu, Ignacio
A1 Valdés, Nuria
A1 Paja, Miguel
A1 Díez, Juan José
A1 Biagetti, Betina
K1 Acromegaly
K1 Clinical practice
K1 Guidelines
K1 Patient management
AB The ACROPRAXIS program aims to describe the management of acromegaly in Spain and provide guidance. Ninety-three endocrinologists were organized into 13 panels to discuss the practical issues in managing acromegaly. Based on the key learnings, an online Delphi survey with 62 statements was performed, so those statements achieving consensus could be used as guidance. Statements were rated on a 9-point scale (9, full agreement; consensus > 66.6% of response in the same tertile). Ninety-two endocrinologists (98.8%) answered two rounds of the survey (mean age 47.6 years; 59.8% women; median 18.5 years of experience). Consensus was achieved for 49 (79%) statements. The levels of insulin-like growth factor I (IGFI) is the preferred screening test. If IGFI levels 1-1.3 ULN, the test is repeated and growth hormone (GH) after oral glucose tolerance test (OGTT) is assessed. A pituitary magnetic resonance is performed after biochemical diagnosis. Surgery is the first treatment choice for patients with microadenoma or macroadenoma with/without optical pathway compression. Pre-surgical somatostatin analogues (SSA) are indicated when surgery is delayed and/or to reduce anaesthesia-associated risks. After unsuccessful surgery, reintervention is performed if the residual tumor is resectable, while if non-resectable, SSA are administered. Follow-up First biochemical and clinical controls are performed 1-3 months after surgery. Disease remission is considered if random GH levels are  Current clinical management for acromegaly is homogeneous across Spain and generally follows clinical guidelines.
YR 2020
FD 2020
LK http://hdl.handle.net/10668/14809
UL http://hdl.handle.net/10668/14809
LA en
DS RISalud
RD Apr 8, 2025