IGF1 and acromegaly: The restricted number of included patients reflects the stringent inclusion criteria and the rarity of the acromegaly disease, as well as the selection of a consecutive cohort of acromegalic patients resistant to fg-SRLs and treated with second-line therapies, Pegvisomant and Pasireotide Lar, to examine the interactions of GHR, bone health and GH/IGF lowering therapies in a cohort of acromegalic patients affected from a more difficult/aggressive disease.