In parallel, the treatment with GH/IGF-I lowering therapies (such as fg-SRLs, Pegvisomant and Pasireotide Lar) was proved to decrease the frequency of i-VFs in acromegaly through an indirect effect on bone metabolism, mediated by the reduction/normalization of circulating levels of IGF-I and/or GH (14, 15). This evidence concerns the gene IGF1 and acromegaly.