Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,808 questions · 8,953 findings · 827 reviews · Headline outcomes only

No studies found 1,891 · 21.1%GRADE not reported 380 · 4.2%Very low 2,100 · 23.5%Low 2,449 · 27.4%Moderate 1,684 · 18.8%High 449 · 5%

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Surgery vs preoperative pharmacological therapy and surgery

Adverse events · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes adverse events compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Surgery vs preoperative pharmacological therapy and surgery

Surgery for recurrent or persistent disease · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes surgery for recurrent or persistent disease compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Surgery vs Pharmacological therapy

Health‐related quality of life Mean AcroQoL score (0‐100) · adults with growth‐hormone secreting pituitary adenomas

Surgery alone showed no clear difference in health‐related quality of life Mean AcroQoL score (0‐100) compared with pharmacological therapy alone (low certainty).

1 finding from 1 review

Surgery vs preoperative pharmacological therapy and surgery

Disease‐related complications Intubation difficulties requiring postponement of surgery · adults with growth‐hormone secreting pituitary adenomas

It is very uncertain whether surgery alone changes disease‐related complications Intubation difficulties requiring… compared with preoperative pharmacological therapy and surgery (very low certainty).

1 finding from 1 review

Summary of findings table ‐ Fitusiran prophylaxis vs on‐demand therapy

Proportion with zero bleeds · people with inhibitors

Summary of findings table ‐ Fitusiran prophylaxis probably leads to higher proportion with zero bleeds compared with on‐demand therapy (moderate certainty).

1 finding from 1 review