{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:35:05Z","timestamp":1777300505998,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>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\u2010up exist. However, not all recommendations are strictly evidence\u2010based. To evaluate consensus on the treatment and follow\u2010up of patients with acromegaly in the Nordic countries.<\/jats:p><\/jats:sec>Methods<\/jats:title>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\u2010up of patients with acromegaly. Dedicated endocrinologists (n<\/jats:italic>\u2009=\u200947) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert\u2010type scale (1\u22127). Consensus was defined as \u226580% of panelists rating their agreement as \u22655 or \u22643 on the Likert\u2010type scale.<\/jats:p><\/jats:sec>Results<\/jats:title>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\u2010generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first\u2010generation SSA and pegvisomant as second\u2010 or third\u2010line 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.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>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\u2010based data.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15095","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T17:04:09Z","timestamp":1718211849000},"page":"263-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Acromegaly management in the Nordic countries:\u00a0A Delphi consensus survey"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-558X","authenticated-orcid":false,"given":"Mai 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