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Timely Diagnosis and Individualized Management of Acromegaly: A Case Example

  • Authors: Adriana G. Ioachimescu, MD, PhD
  • CME Released: 6/13/2022
  • Valid for credit through: 6/13/2023, 11:59 PM EST
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Target Audience and Goal Statement

This activity is intended for endocrinologists, internists, and other healthcare professionals who may care for patients with acromegaly.

The goal of this initiative is to improve awareness, achieve a timely diagnosis, and individualize the clinical management of acromegaly.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Clinical manifestations of and comorbidities associated with acromegaly
    • Strategies for individualizing medical therapy for patients with acromegaly


Disclosures for additional planners can be found here.


  • Adriana G Ioachimescu, MD, PhD

    Professor of Medicine (Endocrinology) and Neurosurgery
    Co-Director, Emory Pituitary Center
    Emory University School of Medicine
    Atlanta, Georgia, United States


    The opinions expressed are those of Dr Ioachimescu and do not necessarily reflect the views of Emory University or Emory Healthcare. Dr Ioachimescu’s participation in this activity does not constitute or imply endorsement by Emory University or Emory Healthcare.

    Disclosure: Adriana G. Ioachimescu, MD, PhD, has the following relevant financial relationships:
    Consultant or advisor for: Amryt; Ipsen Biopharmaceutical; HRA-Pharma; Recordati Rare Diseases, Inc; Strongbridge Biopharma
    Research funding from: Amryt; HRA-Pharma; Recordati Rare Diseases Inc; Xeris


  • Anne G. Le, PharmD

    Senior Medical Education Director, Medscape, LLC


    Disclosure: Anne G. Le, PharmD, has no relevant financial relationships. 

  • Kevan H. Chambers, FRSPH, CBiol, MRSB

    Medical Writer, Medscape, LLC 


    Disclosure: Kevan H. Chambers, FRSPH, CBiol, MSRB, has no relevant financial relationships. 

Compliance Reviewer

  • Yaisanet Oyola, MD

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Yaisanet Oyola, MD, has no relevant financial relationships.

Peer Reviewer

Skand Shekhar

Assistant Research Physician (Asst Prof), National Institutes of Health

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

Accreditation Statements

Developed through a partnership between Medscape and the Endocrine Society.

As a provider of continuing medical education (CME) accredited by the Accreditation Council for Continuing Medical Education, the Endocrine Society has a policy of ensuring that the content and quality of this educational activity are balanced, independent, objective, and scientifically rigorous. The scientific content of this activity was developed under the supervision of the Endocrine Society's Special Programs Committee (SPC). The commercial supporter(s) of this activity have no influence over the planning of this CME activity.

    For Physicians

  • The Endocrine Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Endocrine Society has achieved accreditation with commendation. 

    The Endocrine Society designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 


    As a provider of CME accredited by the Accreditation Council for Continuing Medical 

    Education, the Endocrine Society has a policy of ensuring that the content and 

    quality of this educational activity are balanced, independent, objective, and 

    scientifically rigorous. The scientific content of this activity was developed under the 

    supervision of the Endocrine Society’s guideline task force. 


    The faculty, committee members, and staff who are in position to control the 

    content of this activity are required to disclose to the Endocrine Society and to 

    learners any relevant financial relationship(s) of the individual or spouse/partner 

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    USE OF PROFESSIONAL JUDGMENT: The educational content in this activity relates 

    to basic principles of diagnosis and therapy and does not substitute for individual 

    patient assessment based on the health care provider’s examination of the patient 

    and consideration of laboratory data and other factors unique to the patient. 

    Standards in medicine change as new data become available. 

    DRUGS AND DOSAGES: When prescribing medications, the physician is advised to 

    check the product information sheet accompanying each drug to verify conditions 

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    POLICY ON UNLABELED/OFF-LABEL USE: The Endocrine Society has determined 

    that disclosure of unlabeled/off-label or investigational use of commercial 

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    be disclosed to the learners at the beginning of the presentation. Uses of specific 

    therapeutic agents, devices, and other products discussed in this educational 

    activity may not be the same as those indicated in product labeling approved by the 

    Food and Drug Administration (FDA). The Endocrine Society requires that any 

    discussions of such “off-label” use be based on scientific research that conforms to 

    generally accepted standards of experimental design, data collection, and data 

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    learners should review the complete prescribing information, including indications, 

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For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

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There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Timely Diagnosis and Individualized Management of Acromegaly: A Case Example

Authors: Adriana G. Ioachimescu, MD, PhDFaculty and Disclosures

CME Released: 6/13/2022

Valid for credit through: 6/13/2023, 11:59 PM EST



  1. Caron P, et al. Signs and symptoms of acromegaly at diagnosis: the physician's and the patient's perspectives in the ACRO-POLIS study. Endocrine. 2019;63:120-129.
  2. Kreitschmann-Andermahr I, et al. Oro-dental pathologies in acromegaly. Endocrine. 2018;60:323-328.
  3. De Stefani A, et al. Oral manifestations and maxillo-facial features in the acromegalic patient: a literature review. J Clin Med. 2022;11:1092.
  4. Colao A, et al. Acromegaly. Nat Rev Dis Primers. 2019;5:20.
  5. Vouzouneraki K, et al. Carpal tunnel syndrome in acromegaly: a nationwide study. Eur J Endocrinol. 2021;184:209-216.
  6. Ioachimescu AG, et al. Gender differences and temporal trends over two decades in acromegaly: a single center study in 112 patients. Endocrine. 2020;67:423-432.
  7. Kreitschmann-Andermahr I, et al. Diagnosis and management of acromegaly: the patient's perspective. Pituitary. 2016;19:268-276.
  8. Petrossians P, et al. Acromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) Database. Endocr Relat Cancer. 2017;24:505-518.
  9. Park SH, et al. Age- and sex-specific differences as predictors of surgical remission among patients with acromegaly. J Clin Endocrinol Metab. 2018 1;103:909-916.
  10. Katznelson L, et al. Hypogonadism in patients with acromegaly: data from the multi-centre acromegaly registry pilot study. Clin Endocrinol (Oxf). 2001;54:183-188.
  11. Ioachimescu AG, et al. Racial disparities in acromegaly and Cushing's disease: a referral center study in 241 patients. Correction in: J Endocr Soc. 2022 Mar;6:bvac040. J Endocr Soc. 2021;6:bvab176.
  12. Katznelson L, et al; Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99:3933-3951.
  13. Fleseriu M, et al. A Pituitary Society update to acromegaly management guidelines. Pituitary. 2021;24:1-13.
  14. Parkinson C, et al; Sensus Acromegaly Study Group. The relationship between serum GH and serum IGF-I in acromegaly is gender-specific. J Clin Endocrinol Metab. 2001;86:5240-5244.
  15. Coopmans EC, et al. Predictors for remission after transsphenoidal surgery in acromegaly: a Dutch multicenter study. J Clin Endocrinol Metab. 2021;1061783-1792.
  16. Anthony JR, et al. Significant elevation of growth hormone level impacts surgical outcomes in acromegaly. Endocr Pract. 2015;21:1001-1009.
  17. Giraldi EA, et al. Incidentally detected acromegaly: single-center study of surgically treated patients over 22 years. J Investig Med. 2021;69:351-357.
  18. Briceno V, et al. Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone‐secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta‐analysis. Neurol Res. 2017;39:387‐398.
  19. Paragliola RM, et al. Novel somatostatin receptor ligands therapies for acromegaly. Front Endocrinol (Lausanne). 2018;9:78.
  20. Octreotide acetate for injectable suspension [prescribing information]. Approved 1988. Revised March 2021.
  21. Octeotride delayed-release capsules, for oral use [prescribing information]. Approved 1988. Revised March 2022.
  22. Giustina A, et al. Pegvisomant in acromegaly: an update. Correction in: J Endocrinol Invest. 2018 Feb;41:267. J Endocrinol Invest. 2017;40:577-589.
  23. Gadelha MR, et al. The future of somatostatin receptor ligands in acromegaly. J Clin Endocrinol Metab. 2022;107:297-308.
  24. Gadelha MR, et al. Risk factors and management of pasireotide-associated hyperglycemia in acromegaly. Endocr Connect. 2020;9:1178-1190.
  25. Strasburger CJ, et al. Patient-reported outcomes of parenteral somatostatin analogue injections in 195 patients with acromegaly. Eur J Endocrinol. 2016;174:355-362.
  26. Geer EB, et al. Observed discordance between outcomes reported by acromegaly patients and their treating endocrinology medical provider. Pituitary. 2020;23:140-148.
  27. Fleseriu M, et al. An evaluation of the Acromegaly Treatment Satisfaction Questionnaire (Acro-TSQ) in adult patients with acromegaly, including correlations with other patient-reported outcome measures: data from two large multicenter international studies. Pituitary. 2020;23:347-358.
  28. Melmed S, et al. Safety and efficacy of oral octreotide in acromegaly: results of a multicenter phase III trial. Correction in: J Clin Endocrinol Metab. 2020 Dec;105:dgaa637. J Clin Endocrinol Metab. 2015;100:1699-1708.
  29. Samson SL, et al. Maintenance of acromegaly control in patients switching from injectable somatostatin receptor ligands to oral octreotide. J Clin Endocrinol Metab. 2020;105:e3785-e3797.
  30. Fleseriu M, et al. Maintenance of response to oral octreotide compared with injectable somatostatin receptor ligands in patients with acromegaly: a phase 3, multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2022;10:102-111.
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