{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:43:33Z","timestamp":1790279013240,"version":"4.1.0"},"reference-count":201,"publisher":"The Endocrine Society","issue":"Supplement_1","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acromegaly is a chronic multisystem disorder in which growth hormone and insulin-like growth factor 1 excess cause progressive somatic, metabolic, psychological, and functional morbidity. Although biochemical control improves outcomes, many patients continue to experience persistent symptoms, impaired health-related quality of life (HRQoL), and substantial treatment burden. This review synthesizes data from clinical trials, longitudinal cohorts, registry studies, and patient-reported outcome (PRO) research evaluating physical symptoms, HRQoL, mood, interpersonal functioning, work productivity, and financial burden in acromegaly. We examine validated PRO instruments and the impact of medical, surgical, and radiation therapies on the patient experience. Fatigue, musculoskeletal pain, arthropathy, sleep disturbance, and body-image concerns are highly prevalent and frequently persist despite biochemical remission. HRQoL remains impaired in physical, psychological, and social domains, with depression and anxiety affecting a substantial proportion of patients. Treatment-related factors, including injection burden, breakthrough symptoms, gastrointestinal effects, and financial and surveillance demands further reduce well-being and productivity. PRO tools, including the Acromegaly Quality of Life Questionnaire, Patient-Assessed Acromegaly Symptom Questionnaire, Acromegaly Treatment Satisfaction Questionnaire, and the Acromegaly Symptom Diary, reveal discordance between biochemical control and PROs, highlighting the need for standardized PRO assessment and validated minimal important difference thresholds. New oral therapies and long-acting formulations may reduce treatment burden, but comparative PRO data are limited. Despite therapeutic advances, acromegaly remains associated with considerable symptom burden and impaired HRQoL. Patient-centered care requires systematic PRO incorporation, multidisciplinary management of comorbidities, attention to treatment burden, and shared decision-making.<\/jats:p>","DOI":"10.1210\/clinem\/dgag122","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:45:20Z","timestamp":1773924320000},"page":"S123-S145","source":"Crossref","is-referenced-by-count":1,"title":["The acromegaly patient experience: burden of treatment and quality of life"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3722-1889","authenticated-orcid":false,"given":"Eliza B","family":"Geer","sequence":"first","affiliation":[{"name":"Departments of Medicine and Neurosurgery, Multidisciplinary Pituitary and Skull Base Tumor Center, Memorial Sloan Kettering Cancer Center , New York, NY 10021 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Sisco","sequence":"additional","affiliation":[{"name":"Acromegaly Community , Grove, OK 74344 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"issue":"10","key":"2026060410075917800_dgag122-B1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1056\/NEJMra1810772","article-title":"Pituitary-tumor endocrinopathies","volume":"382","author":"Melmed","year":"2020","journal-title":"N Engl J Med"},{"issue":"1","key":"2026060410075917800_dgag122-B2","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1210\/er.2018-00115","article-title":"Systemic complications of acromegaly and the impact of the current treatment landscape: an update","volume":"40","author":"Gadelha","year":"2019","journal-title":"Endocr Rev"},{"issue":"2","key":"2026060410075917800_dgag122-B3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s11102-019-01013-2","article-title":"Observed discordance between outcomes reported by acromegaly patients and their treating endocrinology medical provider","volume":"23","author":"Geer","year":"2020","journal-title":"Pituitary"},{"key":"2026060410075917800_dgag122-B4","first-page":"61","article-title":"Article commentary: patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs)","volume":"6","author":"Weldring","year":"2013","journal-title":"Health Serv Insights"},{"issue":"2","key":"2026060410075917800_dgag122-B5","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1046\/j.1365-2265.2002.01597.x","article-title":"Acromegaly Quality of Life Questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties","volume":"57","author":"Webb","year":"2002","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"16","key":"2026060410075917800_dgag122-B6","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1056\/NEJM200004203421604","article-title":"Treatment of acromegaly with the growth hormone\u2013receptor antagonist pegvisomant","volume":"342","author":"Trainer","year":"2000","journal-title":"N Engl J Med"},{"issue":"10","key":"2026060410075917800_dgag122-B7","doi-asserted-by":"crossref","first-page":"3853","DOI":"10.1210\/jc.2008-0669","article-title":"Quality of life in acromegalic patients during long-term somatostatin analog treatment with and without pegvisomant","volume":"93","author":"Neggers","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026060410075917800_dgag122-B8","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1530\/eje.1.02312","article-title":"Treatment of acromegaly with the GH receptor antagonist pegvisomant in clinical practice: safety and efficacy evaluation from the German Pegvisomant observational study","volume":"156","author":"Schreiber","year":"2007","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2026060410075917800_dgag122-B9","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1210\/clinem\/dgaa868","article-title":"Improvement in symptoms and health-related quality of life in acromegaly patients: a systematic review and meta-analysis","volume":"106","author":"Broersen","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026060410075917800_dgag122-B10","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s11102-019-00986-4","article-title":"Development of a novel patient-reported measure for acromegaly: the Acro-TSQ","volume":"22","author":"Fleseriu","year":"2019","journal-title":"Pituitary"},{"issue":"4","key":"2026060410075917800_dgag122-B11","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s11102-020-01038-y","article-title":"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","volume":"23","author":"Fleseriu","year":"2020","journal-title":"Pituitary"},{"issue":"1","key":"2026060410075917800_dgag122-B12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s41687-023-00541-7","article-title":"Development and evaluation of the acromegaly symptom diary","volume":"7","author":"Martin","year":"2023","journal-title":"J Patient Rep Outcomes"},{"issue":"3","key":"2026060410075917800_dgag122-B13","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/j.1365-2265.2007.02891.x","article-title":"Treatment of acromegaly improves quality of life, measured by AcroQol","volume":"67","author":"Paisley","year":"2007","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3-4","key":"2026060410075917800_dgag122-B14","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1159\/000095532","article-title":"Quality of life in acromegaly","volume":"83","author":"Webb","year":"2006","journal-title":"Neuroendocrinology"},{"issue":"5","key":"2026060410075917800_dgag122-B15","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1037\/hea0000741","article-title":"PROMIS\u00ae: standardizing the patient voice in health psychology research and practice","volume":"38","author":"Yount","year":"2019","journal-title":"Health Psychol"},{"issue":"4","key":"2026060410075917800_dgag122-B16","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.ecl.2022.04.004","article-title":"Evaluating the impact of acromegaly on quality of life","volume":"51","author":"Coopmans","year":"2022","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"10","key":"2026060410075917800_dgag122-B17","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1007\/s40618-022-01782-x","article-title":"Questionnaire and tools: clinical powerful instrument in acromegaly diagnosis and management","volume":"45","author":"Camerini","year":"2022","journal-title":"J Endocrinol Invest"},{"issue":"7","key":"2026060410075917800_dgag122-B18","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.eprac.2022.04.002","article-title":"Clinical applicability of patient- and clinician-reported outcome tools in the management of patients with acromegaly","volume":"28","author":"Herman","year":"2022","journal-title":"Endocr Pract"},{"issue":"6","key":"2026060410075917800_dgag122-B19","doi-asserted-by":"crossref","first-page":"3337","DOI":"10.1210\/jc.2004-1565","article-title":"Quality of life (QOL) in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire","volume":"90","author":"Rowles","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026060410075917800_dgag122-B20","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s11136-020-02650-y","article-title":"US population norms for the EQ-5D-5L and comparison of norms from face-to-face and online samples","volume":"30","author":"Jiang","year":"2021","journal-title":"Qual Life Res"},{"key":"2026060410075917800_dgag122-B21","doi-asserted-by":"crossref","first-page":"675523","DOI":"10.3389\/fpubh.2021.675523","article-title":"Health-related quality of life in patients with different diseases measured with the EQ-5D-5L: a systematic review","volume":"9","author":"Zhou","year":"2021","journal-title":"Front Public Health"},{"issue":"6","key":"2026060410075917800_dgag122-B22","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/cen.13331","article-title":"Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: results from a 5-years prospective study","volume":"86","author":"Kyriakakis","year":"2017","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2026060410075917800_dgag122-B23","doi-asserted-by":"crossref","first-page":"111487","DOI":"10.1016\/j.jclinepi.2024.111487","article-title":"Systematic review reveals that EQ-5D minimally important differences vary with treatment type and may decrease with increasing baseline score","volume":"174","author":"Cheng","year":"2024","journal-title":"J Clin Epidemiol"},{"key":"2026060410075917800_dgag122-B24","author":"Mapi Research Trust"},{"key":"2026060410075917800_dgag122-B25","doi-asserted-by":"crossref","first-page":"e1202","DOI":"10.1016\/j.wneu.2018.11.017","article-title":"Quality of life changes before and after transsphenoidal surgery for sellar and parasellar lesions","volume":"122","author":"Ishikawa","year":"2019","journal-title":"World Neurosurg"},{"issue":"2","key":"2026060410075917800_dgag122-B26","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000506110","article-title":"Kellner's symptom questionnaire, a highly sensitive patient-reported outcome measure: systematic review of clinimetric properties","volume":"89","author":"Benasi","year":"2020","journal-title":"Psychother Psychosom"},{"issue":"273","key":"2026060410075917800_dgag122-B27","first-page":"185","article-title":"Measuring health status: a new tool for clinicians and epidemiologists","volume":"35","author":"Hunt","year":"1985","journal-title":"J R Coll Gen Pract"},{"issue":"11","key":"2026060410075917800_dgag122-B28","doi-asserted-by":"crossref","first-page":"5369","DOI":"10.1210\/jc.2004-0669","article-title":"Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess","volume":"89","author":"Biermasz","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"issue":"S10","key":"2026060410075917800_dgag122-B29","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1002\/acr.24216","article-title":"Adult measures of general health and health-related quality of life","volume":"72","author":"Busija","year":"2020","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"1","key":"2026060410075917800_dgag122-B30","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/1477-7525-4-88","article-title":"Development and validation of the short version of the psychological general well-being Index (PGWB-S)","volume":"4","author":"Grossi","year":"2006","journal-title":"Health Qual Life Outcomes"},{"key":"2026060410075917800_dgag122-B31","doi-asserted-by":"crossref","first-page":"5152","DOI":"10.1007\/978-94-007-0753-5_2309","volume-title":"Encyclopedia of Quality of Life and Well-Being Research","author":"Grossi","year":"2014"},{"issue":"3","key":"2026060410075917800_dgag122-B32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med Care"},{"issue":"5","key":"2026060410075917800_dgag122-B33","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care"},{"issue":"11","key":"2026060410075917800_dgag122-B34","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0895-4356(98)00081-X","article-title":"Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project","volume":"51","author":"Ware","year":"1998","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"2026060410075917800_dgag122-B35","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection","volume":"30","author":"Ware JE","year":"1992","journal-title":"Med Care"},{"issue":"1","key":"2026060410075917800_dgag122-B36","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s12020-020-02384-4","article-title":"SF-12 or SF-36 in pituitary disease? Toward concise and comprehensive patient-reported outcomes measurements","volume":"70","author":"van der Meulen","year":"2020","journal-title":"Endocrine"},{"issue":"1","key":"2026060410075917800_dgag122-B37","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1369-7625.2010.00650.x","article-title":"Expecting a good quality of life in health: assessing people with diverse diseases and conditions using the WHOQOL-BREF","volume":"15","author":"Skevington","year":"2012","journal-title":"Health Expect"},{"issue":"1","key":"2026060410075917800_dgag122-B38","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1080\/10911359.2021.2000918","article-title":"Examining the World Health Organization's WHOQOL-BREF: assessing the structural and convergent validity in a general U","volume":"33","author":"Archuleta","year":"2023","journal-title":"J Hum Behav Soc Environ"},{"issue":"2","key":"2026060410075917800_dgag122-B39","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1023\/B:QURE.0000018486.91360.00","article-title":"The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group","volume":"13","author":"Skevington","year":"2004","journal-title":"Qual Life Res"},{"issue":"4","key":"2026060410075917800_dgag122-B40","first-page":"140","article-title":"World Health Organization quality-of-life scale (WHOQOL-BREF): analyses of their item response theory properties based on the graded responses model","volume":"5","author":"Vahedi","year":"2010","journal-title":"Iran J Psychiatry"},{"key":"2026060410075917800_dgag122-B41","author":"AbilityLab"},{"issue":"11","key":"2026060410075917800_dgag122-B42","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s40618-016-0476-y","article-title":"Usefulness of an ad hoc questionnaire (Acro-CQ) for the systematic assessment of acromegaly comorbidities at diagnosis and their management at follow-up","volume":"39","author":"Guaraldi","year":"2016","journal-title":"J Endocrinol Invest"},{"issue":"1","key":"2026060410075917800_dgag122-B43","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1210\/clinem\/dgae385","article-title":"Acromegaly disease control maintained after switching from injected somatostatin receptor ligands to oral paltusotine","volume":"110","author":"Gadelha","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026060410075917800_dgag122-B44","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1477-7525-2-13","article-title":"Acromegaly quality of life questionnaire (AcroQoL)","volume":"2","author":"Badia","year":"2004","journal-title":"Health Qual Life Outcomes"},{"issue":"12","key":"2026060410075917800_dgag122-B45","first-page":"3555","article-title":"International multicenter validation study of the SAGIT\u00ae instrument in acromegaly","volume":"106","author":"Giustina","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026060410075917800_dgag122-B46","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s11102-016-0707-4","article-title":"The development and validation of the Leiden Bother and needs questionnaire for patients with pituitary disease: the LBNQ-pituitary","volume":"19","author":"Andela","year":"2016","journal-title":"Pituitary"},{"issue":"4","key":"2026060410075917800_dgag122-B47","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1530\/EJE-19-0344","article-title":"Toward value based health care in pituitary surgery: application of a comprehensive outcome set in perioperative care","volume":"181","author":"Lobatto","year":"2019","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"2026060410075917800_dgag122-B48","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1210\/clinem\/dgab874","article-title":"State of the art of patient-reported outcomes in acromegaly or GH deficiency: a systematic review and meta-analysis","volume":"107","author":"van der Meulen","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026060410075917800_dgag122-B49","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1365-2265.2009.03773.x","article-title":"Change of symptoms and perceived health in acromegalic patients on pegvisomant therapy: a retrospective cohort study within the German Pegvisomant observational study (GPOS)","volume":"73","author":"Sievers","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"2026060410075917800_dgag122-B50","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1037\/0022-006X.56.6.893","article-title":"An inventory for measuring clinical anxiety: psychometric properties","volume":"56","author":"Beck","year":"1988","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"2026060410075917800_dgag122-B51","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1037\/1040-3590.7.4.450","article-title":"Normative values for the Beck anxiety inventory, fear questionnaire, Penn state worry questionnaire, and social phobia and anxiety inventory","volume":"7","author":"Gillis","year":"1995","journal-title":"Psychol Assess"},{"issue":"S11","key":"2026060410075917800_dgag122-B52","doi-asserted-by":"crossref","first-page":"S467","DOI":"10.1002\/acr.20561","article-title":"Measures of anxiety: state-trait anxiety inventory (STAI), Beck anxiety inventory (BAI), and hospital anxiety and depression scale-anxiety (HADS-A)","volume":"63","author":"Julian","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"2","key":"2026060410075917800_dgag122-B53","doi-asserted-by":"crossref","first-page":"e00229","DOI":"10.1002\/edm2.229","article-title":"Differences in quality of life between genders in acromegaly","volume":"4","author":"Ballesteros-Herrera","year":"2021","journal-title":"Endocrinol Diabetes Metab"},{"key":"2026060410075917800_dgag122-B54","doi-asserted-by":"crossref","first-page":"101650","DOI":"10.1016\/j.ghir.2025.101650","article-title":"Impact of disease activity on cognitive and psychological outcomes in acromegaly: a prospective study","volume":"81","author":"Uysal","year":"2025","journal-title":"Growth Horm IGF Res"},{"issue":"3","key":"2026060410075917800_dgag122-B55","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1159\/000066239","article-title":"On the validity of the Beck depression inventory. A review","volume":"31","author":"Richter","year":"1998","journal-title":"Psychopathology"},{"issue":"9","key":"2026060410075917800_dgag122-B56","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1002\/jclp.22188","article-title":"Normative data on the Beck depression inventory\u2013second edition (BDI-II) in college students","volume":"71","author":"Whisman","year":"2015","journal-title":"J Clin Psychol"},{"issue":"6","key":"2026060410075917800_dgag122-B57","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s11102-013-0544-7","article-title":"Impact of treatment satisfaction on quality of life of patients with acromegaly","volume":"17","author":"Kepicoglu","year":"2014","journal-title":"Pituitary"},{"issue":"3","key":"2026060410075917800_dgag122-B58","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1207\/s15327752jpa6703_13","article-title":"Comparison of Beck depression inventories -IA and -II in psychiatric outpatients","volume":"67","author":"Beck","year":"1996","journal-title":"J Pers Assess"},{"key":"2026060410075917800_dgag122-B59","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/978-1-4419-9893-4","volume-title":"STOP, THAT and One Hundred Other Sleep Scales","author":"Shahid","year":"2012"},{"issue":"3","key":"2026060410075917800_dgag122-B60","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1007\/s12020-015-0634-6","article-title":"Impaired decision making and delayed memory are related with anxiety and depressive symptoms in acromegaly","volume":"50","author":"Crespo","year":"2015","journal-title":"Endocrine"},{"issue":"15","key":"2026060410075917800_dgag122-B61","doi-asserted-by":"crossref","first-page":"3269","DOI":"10.1017\/S0033291715001270","article-title":"Minimal clinically important difference on the Beck depression inventory\u2013II according to the patient's perspective","volume":"45","author":"Button","year":"2015","journal-title":"Psychol Med"},{"key":"2026060410075917800_dgag122-B62","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.2147\/NSS.S340950","article-title":"Reliability and efficacy of the Epworth sleepiness scale: is there still a place for it?","volume":"14","author":"Scharf","year":"2022","journal-title":"Nat Sci Sleep"},{"issue":"4","key":"2026060410075917800_dgag122-B63","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.sleep.2006.01.010","article-title":"The influence of age, gender, ethnicity, and insomnia on epworth sleepiness scores: a normative US population","volume":"7","author":"Sanford","year":"2006","journal-title":"Sleep Med"},{"issue":"6","key":"2026060410075917800_dgag122-B64","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the Epworth sleepiness scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"issue":"6","key":"2026060410075917800_dgag122-B65","doi-asserted-by":"crossref","first-page":"226","DOI":"10.3390\/dj13060226","article-title":"Oral health and quality of life in acromegaly: a questionnaire-based study","volume":"13","author":"Bruno","year":"2025","journal-title":"Dent J (Basel)"},{"issue":"3","key":"2026060410075917800_dgag122-B66","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0022-3999(94)00125-O","article-title":"The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue","volume":"39","author":"Smets","year":"1995","journal-title":"J Psychosom Res"},{"issue":"2","key":"2026060410075917800_dgag122-B67","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res"},{"issue":"6","key":"2026060410075917800_dgag122-B68","doi-asserted-by":"crossref","first-page":"563","DOI":"10.5664\/jcsm.27351","article-title":"Relationships between the Pittsburgh sleep quality Index (PSQI), Epworth sleepiness scale (ESS), and clinical\/polysomnographic measures in a community sample","volume":"4","author":"Buysse","year":"2008","journal-title":"J Clin Sleep Med"},{"issue":"5","key":"2026060410075917800_dgag122-B69","doi-asserted-by":"crossref","first-page":"469","DOI":"10.6061\/clinics\/2012(05)11","article-title":"The use of nasal dilator strips as a placebo for trials evaluating continuous positive airway pressure","volume":"67","author":"Amaro","year":"2012","journal-title":"Clinics (Sao Paulo)"},{"issue":"8","key":"2026060410075917800_dgag122-B70","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.3390\/nu13082660","article-title":"Effects of probiotic NVP-1704 on mental health and sleep in healthy adults: an 8-week randomized, double-blind, placebo-controlled trial","volume":"13","author":"Lee","year":"2021","journal-title":"Nutrients"},{"issue":"1","key":"2026060410075917800_dgag122-B71","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4306\/pi.2012.9.1.54","article-title":"A comparison of reliability and construct validity between the original and revised versions of the Rosenberg self-esteem scale","volume":"9","author":"Wongpakaran","year":"2012","journal-title":"Psychiatry Investig"},{"issue":"1","key":"2026060410075917800_dgag122-B72","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1177\/0163278709356187","article-title":"Psychometric properties of the Rosenberg self-esteem scale: overall and across demographic groups living within the United States","volume":"33","author":"Sinclair","year":"2010","journal-title":"Eval Health Prof"},{"key":"2026060410075917800_dgag122-B73","doi-asserted-by":"crossref","first-page":"101439","DOI":"10.1016\/j.ghir.2021.101439","article-title":"Personality traits in acromegalic patients: comparison with patients with non-functioning adenomas and healthy controls","volume":"62","author":"Kan","year":"2022","journal-title":"Growth Horm IGF Res"},{"key":"2026060410075917800_dgag122-B74","author":"American Psychological Association"},{"issue":"4","key":"2026060410075917800_dgag122-B75","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/s11102-021-01136-5","article-title":"Psychosocial effects and clinic reflections of the COVID-19 outbreak in patients with acromegaly and Cushing's disease","volume":"24","author":"Durcan","year":"2021","journal-title":"Pituitary"},{"issue":"4","key":"2026060410075917800_dgag122-B76","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1093\/rheumatology\/38.4.355","article-title":"Determinants of WOMAC function, pain and stiffness scores: evidence for the role of low back pain, symptom counts, fatigue and depression in osteoarthritis, rheumatoid arthritis and fibromyalgia","volume":"38","author":"Wolfe","year":"1999","journal-title":"Rheumatology (Oxford)"},{"issue":"3","key":"2026060410075917800_dgag122-B77","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s12020-022-03106-8","article-title":"Psychological complications in patients with acromegaly: relationships with sex, arthropathy, and quality of life","volume":"77","author":"Cangiano","year":"2022","journal-title":"Endocrine"},{"issue":"1","key":"2026060410075917800_dgag122-B78","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1530\/EJE-21-0209","article-title":"Intramuscular fatty infiltration and physical function in controlled acromegaly","volume":"185","author":"Martel-Duguech","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"2026060410075917800_dgag122-B79","author":"AbilityLab"},{"key":"2026060410075917800_dgag122-B80","doi-asserted-by":"crossref","DOI":"10.23970\/AHRQEPCCER190","volume-title":"Appendix I, MCID Cutoffs. Treatment of Osteoarthritis of the Knee: An Update Review","author":"Newberry","year":"2017"},{"key":"2026060410075917800_dgag122-B81","author":"Reilly Associates"},{"key":"2026060410075917800_dgag122-B82","doi-asserted-by":"publisher","first-page":"kqaf097","DOI":"10.1093\/occmed\/kqaf097","article-title":"The work productivity and activity impairment (WPAI) questionnaire","author":"Walker-Bone","year":"2025","journal-title":"Occup Med (Lond)"},{"issue":"3","key":"2026060410075917800_dgag122-B83","doi-asserted-by":"crossref","first-page":"A176","DOI":"10.1016\/j.jval.2015.03.1018","article-title":"Work productivity loss and activity impairment across nineteen medical conditions in a representative sample of US adults","volume":"18","author":"Witt","year":"2015","journal-title":"Value Health"},{"issue":"1","key":"2026060410075917800_dgag122-B84","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s12020-018-1764-4","article-title":"Signs and symptoms of acromegaly at diagnosis: the physician's and the patient's perspectives in the ACRO-POLIS study","volume":"63","author":"Caron","year":"2019","journal-title":"Endocrine"},{"issue":"11","key":"2026060410075917800_dgag122-B85","doi-asserted-by":"crossref","first-page":"3933","DOI":"10.1210\/jc.2014-2700","article-title":"Acromegaly: an Endocrine Society clinical practice guideline","volume":"99","author":"Katznelson","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026060410075917800_dgag122-B86","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s11102-014-0561-1","article-title":"Towards a better quality of life (QoL) for patients with pituitary diseases: results from a focus group study exploring QoL","volume":"18","author":"Andela","year":"2015","journal-title":"Pituitary"},{"issue":"1","key":"2026060410075917800_dgag122-B87","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s11102-016-0772-8","article-title":"Acromegaly: clinical features at diagnosis","volume":"20","author":"Vilar","year":"2017","journal-title":"Pituitary"},{"issue":"5","key":"2026060410075917800_dgag122-B88","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1007\/s11102-019-00966-8","article-title":"Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity","volume":"22","author":"Fatti","year":"2019","journal-title":"Pituitary"},{"issue":"2","key":"2026060410075917800_dgag122-B89","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1530\/EJE-12-0147","article-title":"Progression of acromegalic arthropathy despite long-term biochemical control: a prospective, radiological study","volume":"167","author":"Claessen","year":"2012","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2026060410075917800_dgag122-B90","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ghir.2010.02.003","article-title":"Clinical osteoarthritis predicts physical and psychological QoL in acromegaly patients","volume":"20","author":"Wassenaar","year":"2010","journal-title":"Growth Horm IGF Res"},{"issue":"5","key":"2026060410075917800_dgag122-B91","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1530\/EJE-07-0838","article-title":"Impact of musculoskeletal disease on quality of life in long-standing acromegaly","volume":"158","author":"Miller","year":"2008","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"2026060410075917800_dgag122-B92","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1210\/jc.2004-2297","article-title":"Morbidity after long-term remission for acromegaly: persisting joint-related complaints cause reduced quality of life","volume":"90","author":"Biermasz","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026060410075917800_dgag122-B93","doi-asserted-by":"crossref","first-page":"R1","DOI":"10.1093\/ejendo\/lvad097","article-title":"The socioeconomic burden of acromegaly","volume":"189","author":"St\u00f6rmann","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2026060410075917800_dgag122-B94","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/S0889-8529(18)30205-6","article-title":"Rheumatologic and skeletal changes in acromegaly","volume":"21","author":"Lieberman","year":"1992","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"3","key":"2026060410075917800_dgag122-B95","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/ejendo\/lvaf047","article-title":"Musculoskeletal disease in acromegaly-a population-based registry study","volume":"192","author":"Rosendal","year":"2025","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026060410075917800_dgag122-B96","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1007\/s11102-022-01256-6","article-title":"Determinants of skeletal fragility in acromegaly: a systematic review and meta-analysis","volume":"25","author":"de Moura C","year":"2022","journal-title":"Pituitary"},{"issue":"5","key":"2026060410075917800_dgag122-B97","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1530\/EJE-17-0468","article-title":"Bone microarchitecture and estimated bone strength in men with active acromegaly","volume":"177","author":"Silva","year":"2017","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026060410075917800_dgag122-B98","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1530\/EJE-20-0415","article-title":"Progression of vertebral fractures in long-term controlled acromegaly: a 9-year follow-up study","volume":"183","author":"Pelsma","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2026060410075917800_dgag122-B99","doi-asserted-by":"crossref","first-page":"e3285","DOI":"10.1210\/clinem\/dgaa363","article-title":"Treatment of acromegalic osteopathy in real-life clinical practice: the BAAC (bone active drugs in acromegaly) study","volume":"105","author":"Mazziotti","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"2026060410075917800_dgag122-B100","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1530\/ERC-17-0253","article-title":"Acromegaly at diagnosis in 3173 patients from the Li\u00e8ge Acromegaly Survey (LAS) database","volume":"24","author":"Petrossians","year":"2017","journal-title":"Endocr Relat Cancer"},{"issue":"5","key":"2026060410075917800_dgag122-B101","doi-asserted-by":"crossref","first-page":"R67","DOI":"10.1530\/EJE-19-1023","article-title":"Management of endocrine disease: does gender matter in the management of acromegaly?","volume":"182","author":"Lenders","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026060410075917800_dgag122-B102","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1097\/MED.0000000000000650","article-title":"Acromegaly: achieving timely diagnosis and improving outcomes by personalized care","volume":"28","author":"Ioachimescu","year":"2021","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"issue":"6","key":"2026060410075917800_dgag122-B103","doi-asserted-by":"crossref","first-page":"e097804","DOI":"10.1136\/bmjopen-2024-097804","article-title":"Estimating diagnostic delay in patients with pituitary adenomas in Sweden: a cross-sectional study","volume":"15","author":"Forsgren","year":"2025","journal-title":"BMJ Open"},{"issue":"1","key":"2026060410075917800_dgag122-B104","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/cen.14750","article-title":"Sex difference in patients with controlled acromegaly-a multicentre survey","volume":"98","author":"Dal","year":"2023","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2026060410075917800_dgag122-B105","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1159\/000375451","article-title":"Quality of life in acromegaly","volume":"103","author":"Webb","year":"2016","journal-title":"Neuroendocrinology"},{"issue":"1","key":"2026060410075917800_dgag122-B106","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1507\/endocrj.EJ22-0241","article-title":"Self-reported symptoms in patients with acromegaly: a 6-month follow-up in a single neurosurgical center","volume":"70","author":"Lin","year":"2023","journal-title":"Endocr J"},{"issue":"1","key":"2026060410075917800_dgag122-B107","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1210\/clinem\/dgaa747","article-title":"Progression of acromegalic arthropathy in long-term controlled acromegaly patients: 9 years of longitudinal follow-up","volume":"106","author":"Pelsma","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026060410075917800_dgag122-B108","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s11102-023-01322-7","article-title":"Prevalence of clinical signs, symptoms and comorbidities at diagnosis of acromegaly: a systematic review in accordance with PRISMA guidelines","volume":"26","author":"Slagboom","year":"2023","journal-title":"Pituitary"},{"issue":"1","key":"2026060410075917800_dgag122-B109","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s12902-020-00595-4","article-title":"Patient reported outcome data from acromegaly patients treated with injectable somatostatin receptor ligands (SRLs) in routine clinical practice","volume":"20","author":"Geer","year":"2020","journal-title":"BMC Endocr Disord"},{"key":"2026060410075917800_dgag122-B110","doi-asserted-by":"crossref","first-page":"1516131","DOI":"10.3389\/fendo.2025.1516131","article-title":"Patient perspectives on acromegaly disease burden: insights from a community meeting","volume":"16","author":"Shah","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026060410075917800_dgag122-B111","doi-asserted-by":"crossref","first-page":"1601661","DOI":"10.3389\/fendo.2025.1601661","article-title":"Fatigue in acromegaly patients: a scoping review","volume":"16","author":"Wang","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"12","key":"2026060410075917800_dgag122-B112","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.1007\/s40618-023-02114-3","article-title":"Osteosarcopenia in acromegaly: reduced muscle quality and increased vertebral fat deposition","volume":"46","author":"Eroglu","year":"2023","journal-title":"J Endocrinol Invest"},{"issue":"3","key":"2026060410075917800_dgag122-B113","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s11102-025-01539-8","article-title":"Muscle dysfunction is associated with poor quality of life in long-term controlled patients with acromegaly","volume":"28","author":"Martel-Duguech","year":"2025","journal-title":"Pituitary"},{"issue":"3","key":"2026060410075917800_dgag122-B114","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1530\/EJE-08-0845","article-title":"High prevalence of arthropathy, according to the definitions of radiological and clinical osteoarthritis, in patients with long-term cure of acromegaly: a case-control study","volume":"160","author":"Wassenaar","year":"2009","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026060410075917800_dgag122-B115","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1007\/s11102-022-01233-z","article-title":"Clinical and radiographic assessment of peripheral joints in controlled acromegaly","volume":"25","author":"Pelsma","year":"2022","journal-title":"Pituitary"},{"issue":"1","key":"2026060410075917800_dgag122-B116","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1210\/clinem\/dgaa750","article-title":"Quality of life and its determinants in patients with treated acromegaly: a cross-sectional nationwide study in China","volume":"106","author":"Guo","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026060410075917800_dgag122-B117","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1530\/EJE-22-0263","article-title":"Global psychological assessment with the evaluation of life and sleep quality and sexual and cognitive function in a large number of patients with acromegaly: a cross-sectional study","volume":"187","author":"Pivonello","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"2026060410075917800_dgag122-B118","doi-asserted-by":"crossref","first-page":"627711","DOI":"10.3389\/fendo.2021.627711","article-title":"Disease and treatment-related burden in patients with acromegaly who are biochemically controlled on injectable somatostatin receptor ligands","volume":"12","author":"Fleseriu","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"3","key":"2026060410075917800_dgag122-B119","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s11154-019-09506-y","article-title":"Current perspectives on the impact of clinical disease and biochemical control on comorbidities and quality of life in acromegaly","volume":"20","author":"Gatto","year":"2019","journal-title":"Rev Endocr Metab Disord"},{"issue":"Suppl","key":"2026060410075917800_dgag122-B120","doi-asserted-by":"crossref","first-page":"S144","DOI":"10.1016\/S1096-6374(03)00072-8","article-title":"How effective are current therapies for acromegaly?","volume":"13","author":"Freda","year":"2003","journal-title":"Growth Horm IGF Res"},{"issue":"3","key":"2026060410075917800_dgag122-B121","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1530\/EJE-19-0784","article-title":"Fractionated radiotherapy and radiosurgery in acromegaly: analysis of 352 patients from the German Acromegaly Registry","volume":"182","author":"Knappe","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026060410075917800_dgag122-B122","doi-asserted-by":"crossref","first-page":"101898","DOI":"10.1016\/j.beem.2024.101898","article-title":"Efficacy and safety of radiosurgery in acromegaly","volume":"38","author":"Albano","year":"2024","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"4","key":"2026060410075917800_dgag122-B123","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1210\/jc.2013-3743","article-title":"Stereotactic radiosurgery for acromegaly","volume":"99","author":"Lee","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026060410075917800_dgag122-B124","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1210\/endrev\/bnaf020","article-title":"Medical treatment of acromegaly: navigating the present, shaping the future","volume":"46","author":"Gadelha","year":"2025","journal-title":"Endocr Rev"},{"issue":"3","key":"2026060410075917800_dgag122-B125","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1530\/EJE-19-0732","article-title":"The effect of treatment on quality of life in patients with acromegaly: a prospective study","volume":"182","author":"Wolters","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2026060410075917800_dgag122-B126","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s11102-022-01206-2","article-title":"Patient-reported outcomes in patients with acromegaly treated with pegvisomant in the ACROSTUDY extension: a real-world experience","volume":"25","author":"Salvatori","year":"2022","journal-title":"Pituitary"},{"issue":"3","key":"2026060410075917800_dgag122-B127","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s11102-022-01224-0","article-title":"Quality of life after long-term biochemical control of acromegaly","volume":"25","author":"Kimball","year":"2022","journal-title":"Pituitary"},{"issue":"3","key":"2026060410075917800_dgag122-B128","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s40618-024-02483-3","article-title":"Anxiety, depression and acromegaly: a systematic review","volume":"48","author":"Silvestro","year":"2025","journal-title":"J Endocrinol Invest"},{"issue":"2","key":"2026060410075917800_dgag122-B129","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s11102-025-01509-0","article-title":"Psychiatric morbidity in acromegaly: a cohort study and meta-analysis of the literature","volume":"28","author":"Matthesen","year":"2025","journal-title":"Pituitary"},{"issue":"10","key":"2026060410075917800_dgag122-B130","doi-asserted-by":"crossref","first-page":"2470","DOI":"10.1210\/clinem\/dgad237","article-title":"Psychopathology in acromegaly-real and perceived","volume":"108","author":"Pivonello","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026060410075917800_dgag122-B131","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1365-2265.2009.03555.x","article-title":"Prevalence of mental disorders in acromegaly: a cross-sectional study in 81 acromegalic patients","volume":"71","author":"Sievers","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2026060410075917800_dgag122-B132","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4158\/EP161373.OR","article-title":"Predictors of quality of life in 165 patients with acromegaly: results from a single-center study","volume":"23","author":"Kreitschmann-Andermahr","year":"2017","journal-title":"Endocr Pract"},{"issue":"1","key":"2026060410075917800_dgag122-B133","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/cen.14309","article-title":"Effects of growth hormone receptor antagonism and somatostatin analog administration on quality of life in acromegaly","volume":"94","author":"Dichtel","year":"2021","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"2026060410075917800_dgag122-B134","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1007\/s12020-014-0166-5","article-title":"Psychological profile and quality of life in patients with acromegaly in Greece. Is there any difference with other chronic diseases?","volume":"47","author":"Anagnostis","year":"2014","journal-title":"Endocrine"},{"issue":"3","key":"2026060410075917800_dgag122-B135","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1159\/000012326","article-title":"Slow-release lanreotide treatment in acromegaly: effects on quality of life","volume":"68","author":"Sonino","year":"1999","journal-title":"Psychother Psychosom"},{"issue":"3","key":"2026060410075917800_dgag122-B136","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1046\/j.1365-2265.2003.01710.x","article-title":"Sandostatin LAR in acromegaly: a 6-week injection interval suppresses GH secretion as effectively as a 4-week interval","volume":"58","author":"Biermasz","year":"2003","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"11","key":"2026060410075917800_dgag122-B137","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1007\/BF03345774","article-title":"Comparison of pegvisomant and long-acting octreotide in patients with acromegaly na\u00efve to radiation and medical therapy","volume":"32","author":"Ghigo","year":"2009","journal-title":"J Endocrinol Invest"},{"issue":"3","key":"2026060410075917800_dgag122-B138","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/BF03346453","article-title":"Efficacy of the new long-acting formulation of lanreotide (lanreotide autogel) in somatostatin analogue-naive patients with acromegaly","volume":"32","author":"Lombardi","year":"2009","journal-title":"J Endocrinol Invest"},{"issue":"4","key":"2026060410075917800_dgag122-B139","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/j.1365-2265.2009.03620.x","article-title":"A randomized, controlled, multicentre trial comparing pegvisomant alone with combination therapy of pegvisomant and long-acting octreotide in patients with acromegaly","volume":"71","author":"Trainer","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"2026060410075917800_dgag122-B140","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1055\/s-0030-1267244","article-title":"Efficacy and acceptability of lanreotide Autogel\u00ae 120 mg at different dose intervals in patients with acromegaly previously treated with octreotide LAR","volume":"119","author":"Schopohl","year":"2011","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"8","key":"2026060410075917800_dgag122-B141","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1210\/jc.2011-0654","article-title":"Cotreatment with pegvisomant and a somatostatin analog (SA) in SA-responsive acromegalic patients","volume":"96","author":"Madsen","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026060410075917800_dgag122-B142","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s11102-013-0533-x","article-title":"Biochemical and quality of life responses to octreotide-LAR in acromegaly","volume":"17","author":"Mangupli","year":"2014","journal-title":"Pituitary"},{"issue":"6","key":"2026060410075917800_dgag122-B143","doi-asserted-by":"crossref","first-page":"e006898","DOI":"10.1136\/bmjopen-2014-006898","article-title":"Change in quality of life in patients with acromegaly after treatment with octreotide LAR: first application of AcroQoL in Korea","volume":"5","author":"Chin","year":"2015","journal-title":"BMJ Open"},{"key":"2026060410075917800_dgag122-B144","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12902-016-0096-8","article-title":"Switching patients with acromegaly from octreotide to pasireotide improves biochemical control: crossover extension to a randomized, double-blind, phase III study","volume":"16","author":"Bronstein","year":"2016","journal-title":"BMC Endocr Disord"},{"issue":"2","key":"2026060410075917800_dgag122-B145","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s11102-015-0693-y","article-title":"Effects of lanreotide Autogel primary therapy on symptoms and quality-of-life in acromegaly: data from the PRIMARYS study","volume":"19","author":"Caron","year":"2016","journal-title":"Pituitary"},{"issue":"1","key":"2026060410075917800_dgag122-B146","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1530\/EJE-17-0546","article-title":"Targeting either GH or IGF-I during somatostatin analogue treatment in patients with acromegaly: a randomized multicentre study","volume":"178","author":"Dal","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026060410075917800_dgag122-B147","doi-asserted-by":"crossref","first-page":"305","DOI":"10.5603\/EP.a2019.0023","article-title":"Efficacy and safety of high-dose long-acting repeatable octreotide as monotherapy or in combination with pegvisomant or cabergoline in patients with acromegaly not adequately controlled by conventional regimens: results of an open-label, multicentre study","volume":"70","author":"Colao","year":"2019","journal-title":"Endokrynol Pol"},{"issue":"1","key":"2026060410075917800_dgag122-B148","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s12020-020-02306-4","article-title":"Soluble Klotho: a possible predictor of quality of life in acromegaly patients","volume":"69","author":"Coopmans","year":"2020","journal-title":"Endocrine"},{"issue":"5","key":"2026060410075917800_dgag122-B149","doi-asserted-by":"crossref","first-page":"512","DOI":"10.5603\/EP.a2021.0075","article-title":"Quality of life in patients with acromegaly receiving lanreotide autogel: a real-world observational study","volume":"72","author":"Bolanowski","year":"2021","journal-title":"Endokrynol Pol"},{"issue":"3","key":"2026060410075917800_dgag122-B150","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1055\/a-1247-4713","article-title":"Multicenter, observational study of lanreotide autogel for the treatment of patients with acromegaly in routine clinical practice in Germany, Austria and Switzerland","volume":"129","author":"St\u00f6rmann","year":"2021","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"12","key":"2026060410075917800_dgag122-B151","doi-asserted-by":"crossref","first-page":"3214","DOI":"10.1210\/clinem\/dgad365","article-title":"MPOWERED trial open-label extension: long-term efficacy and safety data for oral octreotide capsules in acromegaly","volume":"108","author":"Fleseriu","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2026060410075917800_dgag122-B152","doi-asserted-by":"crossref","first-page":"1516899","DOI":"10.3389\/fendo.2025.1516899","article-title":"Impact of strict IGF1 control on quality-of-life scores in patients with acromegaly","volume":"16","author":"Gandhi","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2026060410075917800_dgag122-B153","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1111\/j.1365-2265.2011.04106.x","article-title":"Comparison of primary octreotide-lar and surgical treatment in newly diagnosed patients with acromegaly","volume":"75","author":"Karaca","year":"2011","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"9","key":"2026060410075917800_dgag122-B154","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1007\/s00701-013-1809-7","article-title":"Health-related quality of life and psychiatric symptoms improve effectively within a short time in patients surgically treated for pituitary tumors\u2013a longitudinal study of 106 patients","volume":"155","author":"Milian","year":"2013","journal-title":"Acta Neurochir (Wien)"},{"issue":"1","key":"2026060410075917800_dgag122-B155","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1507\/endocrj.EJ16-0182","article-title":"Changes in quality of life in patients with acromegaly after surgical remission - a prospective study using SF-36 questionnaire","volume":"64","author":"Fujio","year":"2017","journal-title":"Endocr J"},{"key":"2026060410075917800_dgag122-B156","doi-asserted-by":"crossref","first-page":"5363849","DOI":"10.1155\/2020\/5363849","article-title":"Quality of life in patients with acromegaly before and after transsphenoidal surgical resection","volume":"2020","author":"Gu","year":"2020","journal-title":"Int J Endocrinol"},{"issue":"1","key":"2026060410075917800_dgag122-B157","doi-asserted-by":"crossref","first-page":"56","DOI":"10.4158\/EP161439.OR","article-title":"Clinical outcomes and self-reported symptoms in patients with acromegaly: an 8-year follow-up of a lanreotide study","volume":"23","author":"Khairi","year":"2017","journal-title":"Endocr Pract"},{"issue":"6","key":"2026060410075917800_dgag122-B158","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1530\/EJE-19-0762","article-title":"Pasireotide for acromegaly: long-term outcomes from an extension to the phase III PAOLA study","volume":"182","author":"Colao","year":"2020","journal-title":"Eur J Endocrinol"},{"key":"2026060410075917800_dgag122-B159","doi-asserted-by":"crossref","first-page":"1344728","DOI":"10.3389\/fendo.2024.1344728","article-title":"Efficacy of pasireotide LAR for acromegaly: a prolonged real-world monocentric study","volume":"15","author":"Favero","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"12","key":"2026060410075917800_dgag122-B160","doi-asserted-by":"crossref","first-page":"e1571","DOI":"10.1210\/clinem\/dgad378","article-title":"Long-term efficacy and safety of pasireotide in patients with acromegaly: 14 years of single-center real-world experience","volume":"108","author":"Gadelha","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026060410075917800_dgag122-B161","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11154-024-09928-3","article-title":"Real-world evidence of effectiveness and safety of pasireotide in the treatment of acromegaly: a systematic review and meta-analysis","volume":"26","author":"Biagetti","year":"2025","journal-title":"Rev Endocr Metab Disord"},{"issue":"3","key":"2026060410075917800_dgag122-B162","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1530\/EJE-15-1042","article-title":"Patient-reported outcomes of parenteral somatostatin analogue injections in 195 patients with acromegaly","volume":"174","author":"Strasburger","year":"2016","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2026060410075917800_dgag122-B163","doi-asserted-by":"crossref","first-page":"e3644","DOI":"10.1210\/clinem\/dgac385","article-title":"IGF-I variability over repeated measures in patients with acromegaly under long-acting somatostatin receptor ligands","volume":"107","author":"Maione","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026060410075917800_dgag122-B164","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1093\/ejendo\/lvaf200","article-title":"Insulin-like growth factor-I and symptoms of acromegaly according to time since somatostatin receptor ligand injection","volume":"193","author":"Remba-Shapiro","year":"2025","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026060410075917800_dgag122-B165","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1210\/jc.2014-4113","article-title":"Safety and efficacy of oral octreotide in acromegaly: results of a multicenter phase III trial","volume":"100","author":"Melmed","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026060410075917800_dgag122-B166","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/S2213-8587(21)00296-5","article-title":"Maintenance of response to oral octreotide compared with injectable somatostatin receptor ligands in patients with acromegaly: a phase 3, multicentre, randomised controlled trial","volume":"10","author":"Fleseriu","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026060410075917800_dgag122-B167","author":"Palsonify (paltusotine)"},{"issue":"5","key":"2026060410075917800_dgag122-B168","doi-asserted-by":"crossref","first-page":"e148","DOI":"10.1210\/clinem\/dgac643","article-title":"ACROBAT Edge: safety and efficacy of switching injected SRLs to oral paltusotine in patients with acromegaly","volume":"108","author":"Gadelha","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026060410075917800_dgag122-B169","doi-asserted-by":"crossref","first-page":"e1050","DOI":"10.1210\/clinem\/dgaf579","article-title":"Rapid and sustained response of biochemically uncontrolled acromegaly to once-daily oral paltusotine treatment","volume":"111","author":"Biller","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026060410075917800_dgag122-B170","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1530\/EJE-21-1071","article-title":"Virtual education programming for patients with acromegaly: a pilot study","volume":"186","author":"Geer","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"2026060410075917800_dgag122-B171","doi-asserted-by":"crossref","first-page":"899","DOI":"10.3389\/fendo.2019.00899","article-title":"Importance of illness acceptance among other factors affecting quality of life in acromegaly","volume":"10","author":"Jawiarczyk-Przyby\u0142owska","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"1","key":"2026060410075917800_dgag122-B172","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s13023-024-03246-2","article-title":"Quality of life in patients with acromegaly: a scoping review","volume":"19","author":"Wang","year":"2024","journal-title":"Orphanet J Rare Dis"},{"key":"2026060410075917800_dgag122-B173","author":"Huang"},{"key":"2026060410075917800_dgag122-B174","doi-asserted-by":"crossref","first-page":"819330","DOI":"10.3389\/fendo.2022.819330","article-title":"The effect of aging on quality of life in acromegaly patients under treatment","volume":"13","author":"Yamamoto","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"19","key":"2026060410075917800_dgag122-B175","doi-asserted-by":"crossref","first-page":"6309","DOI":"10.3390\/jcm12196309","article-title":"The relationship between the burden of acromegaly, associated comorbidities, complications and disease status","volume":"12","author":"Elbaum","year":"2023","journal-title":"J Clin Med"},{"issue":"11","key":"2026060410075917800_dgag122-B176","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.4158\/EP161397.OR","article-title":"Incidence and prevalence of acromegaly in the United States: a claims-based analysis","volume":"22","author":"Broder","year":"2016","journal-title":"Endocr Pract"},{"issue":"9","key":"2026060410075917800_dgag122-B177","doi-asserted-by":"crossref","first-page":"e250069","DOI":"10.57264\/cer-2025-0069","article-title":"Healthcare utilization and costs among patients with acromegaly in the United States","volume":"14","author":"Quock","year":"2025","journal-title":"J Comp Eff Res"},{"issue":"1","key":"2026060410075917800_dgag122-B178","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1023\/A:1009965803750","article-title":"Epidemiology of acromegaly","volume":"2","author":"Holdaway","year":"1999","journal-title":"Pituitary"},{"issue":"6","key":"2026060410075917800_dgag122-B179","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1530\/EJE-20-0019","article-title":"Prolonged diagnostic delay in acromegaly is associated with increased morbidity and mortality","volume":"182","author":"Esposito","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026060410075917800_dgag122-B180","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s11102-022-01266-4","article-title":"Impact of the diagnostic delay of acromegaly on bone health: data from a real life and long term follow-up experience","volume":"25","author":"Chiloiro","year":"2022","journal-title":"Pituitary"},{"issue":"3","key":"2026060410075917800_dgag122-B181","doi-asserted-by":"crossref","first-page":"618","DOI":"10.3171\/2021.11.JNS212137","article-title":"Determinants of immediate and long-term remission after initial transsphenoidal surgery for acromegaly and outcome patterns during follow-up: a longitudinal study on 659 patients","volume":"137","author":"Guo","year":"2022","journal-title":"J Neurosurg"},{"key":"2026060410075917800_dgag122-B182","author":"Food and Drug Administration (FDA)"},{"issue":"1","key":"2026060410075917800_dgag122-B183","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1186\/s12877-021-02549-4","article-title":"Multidimensional geriatric evaluation in acromegaly: a comparative cross-sectional study","volume":"21","author":"Gagliardi","year":"2021","journal-title":"BMC Geriatr"},{"issue":"10","key":"2026060410075917800_dgag122-B184","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.eprac.2021.04.412","article-title":"Health benefit costs and absenteeism among employed patients with acromegaly","volume":"27","author":"Yuen","year":"2021","journal-title":"Endocr Pract"},{"issue":"1","key":"2026060410075917800_dgag122-B185","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1080\/13102818.2019.1680317","article-title":"Economic and pharmaco-economic analysis of acromegaly treatment: a systematic review","volume":"33","author":"Kamusheva","year":"2019","journal-title":"Biotechnol Biotechnol Equip"},{"issue":"4","key":"2026060410075917800_dgag122-B186","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s11154-020-09588-z","article-title":"Multidisciplinary management of acromegaly: a consensus","volume":"21","author":"Giustina","year":"2020","journal-title":"Rev Endocr Metab Disord"},{"key":"2026060410075917800_dgag122-B187"},{"key":"2026060410075917800_dgag122-B188"},{"issue":"8","key":"2026060410075917800_dgag122-B189","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1007\/s40618-023-02299-7","article-title":"Long-term pasireotide therapy in acromegaly: extensive real-life experience of a referral center","volume":"47","author":"Pirchio","year":"2024","journal-title":"J Endocrinol Invest"},{"key":"2026060410075917800_dgag122-B190"},{"key":"2026060410075917800_dgag122-B191"},{"issue":"3","key":"2026060410075917800_dgag122-B192","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.eprac.2021.12.017","article-title":"Personalized medical treatment of patients with acromegaly: a review","volume":"28","author":"Lim","year":"2022","journal-title":"Endocr Pract"},{"key":"2026060410075917800_dgag122-B193"},{"key":"2026060410075917800_dgag122-B194"},{"issue":"3","key":"2026060410075917800_dgag122-B195","doi-asserted-by":"crossref","first-page":"801","DOI":"10.3171\/2021.2.JNS204440","article-title":"Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and international stereotactic radiosurgery society practice recommendations","volume":"136","author":"Mathieu","year":"2022","journal-title":"J Neurosurg"},{"issue":"3","key":"2026060410075917800_dgag122-B196","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1111\/cen.14346","article-title":"Gamma knife radiosurgery for acromegaly: evaluating the role of the biological effective dose associated with endocrine remission in a series of 42 consecutive cases","volume":"94","author":"Balossier","year":"2021","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"4","key":"2026060410075917800_dgag122-B197","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1210\/jc.2005-1616","article-title":"Conventional pituitary irradiation is effective in lowering serum growth hormone and insulin-like growth factor-I in patients with acromegaly","volume":"91","author":"Jenkins","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"2026060410075917800_dgag122-B198","doi-asserted-by":"crossref","first-page":"3779","DOI":"10.1210\/jcem.85.10.6870","article-title":"Hormonal and metabolic effects of radiotherapy in acromegaly: long-term results in 128 patients followed in a single center","volume":"85","author":"Barrande","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026060410075917800_dgag122-B199","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s11102-023-01360-1","article-title":"Consensus on criteria for acromegaly diagnosis and remission","volume":"27","author":"Giustina","year":"2024","journal-title":"Pituitary"},{"issue":"19","key":"2026060410075917800_dgag122-B200","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1056\/NEJMra2409076","article-title":"Acromegaly","volume":"393","author":"Giustina","year":"2025","journal-title":"N Engl J Med"},{"issue":"6","key":"2026060410075917800_dgag122-B201","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1210\/clinem\/dgae707","article-title":"Octreotide subcutaneous depot for acromegaly: a randomized, double-blind, placebo-controlled phase 3 trial, ACROINNOVA 1","volume":"110","author":"Ferone","year":"2025","journal-title":"J Clin Endocrinol Metab"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgag122\/68130177\/dgag122.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/Supplement_1\/S123\/68130177\/dgag122.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/Supplement_1\/S123\/68130177\/dgag122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:08:27Z","timestamp":1780582107000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/111\/Supplement_1\/S123\/8660332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":201,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2026,4,22]]},"published-print":{"date-parts":[[2026,6,4]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgag122","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,4,22]]}}}