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In patients with poor clinical conditions or who refuse surgery, primary\nmedical treatment should be offered, firstly with somatostatin analogs (SSAs). In patients who do not\nreach hormonal targets with first-generation depot SSAs, a second pharmacological option with pasireotide\nLAR or pegvisomant (alone or combined with SSA) should be offered. Irradiation could be\nproposed to patients with surgical remnants who would like to be free from long-term medical therapies\nor those with persistent disease activity or tumor growth despite surgery or medical therapy. Since\nthe therapeutic tools available enable therapeutic targets to be achieved in most cases, the challenge is\nto focus more on the quality of life.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1871530320666200129113328","type":"journal-article","created":{"date-parts":[[2020,1,29]],"date-time":"2020-01-29T13:58:01Z","timestamp":1580306281000},"page":"1144-1155","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 2: Therapeutic Issues"],"prefix":"10.2174","volume":"20","author":[{"given":"Renato","family":"Cozzi","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Niguarda Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-9770","authenticated-orcid":true,"given":"Maria R.","family":"Ambrosio","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Attanasio","sequence":"additional","affiliation":[{"name":"Endocrinology Service, IRCCS Orthopedic Institute Galeazzi, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8865-0723","authenticated-orcid":true,"given":"Alessandro","family":"Bozzao","sequence":"additional","affiliation":[{"name":"Neuroradiology, S. 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