Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

Kołtowska-Häggström, Maria; Mattsson, Anders; Shalet, Stephen M

doi:10.1530/eje-09-0266

Cited by 52 publications

(44 citation statements)

References 67 publications

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“…Other PROs such as information about personal situation, social functioning, annual sick-leave days and healthcare utilisation were self-reported in the KIMS Patient Life Situation Forms (KIMS PLSF) (20). The level of and satisfaction with physical activity were measured using visual analogue scales, and satisfaction with GH treatment was assessed using a five-point Likert scale.…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Yuen

Kołtowska-Häggström

Cook³

et al. 2013

European Journal of Endocrinology

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Objective: Adults with childhood-onset (CO) craniopharyngioma (COCP) have poor quality of life (QoL) and clinical outcomes, but few studies have compared these patients with adults with other causes of CO hypothalamic-pituitary dysfunction. In this study, we compared baseline clinical characteristics and patient-reported outcomes before starting GH replacement therapy in adults with GH deficiency (GHD) due to COCP with those of adults either with CO idiopathic/congenital hypopituitarism (COH) or with CO extrasellar (COE) tumours, and evaluated the 1-and 5-year effects of GH replacement therapy. Subjects and methods: Retrospective analysis of the data recorded in KIMS (Pfizer International Metabolic Database) was carried out. Patients with COCP, COH and COE tumours were evaluated at baseline, and after 1 and 5 years of therapy. Results: Compared with COH and COE patients, more COCP patients underwent surgery, had greater abnormalities of body composition and higher prevalence of pituitary hormone deficits (all P!0.001), but comparable fasting glucose, HbA1c, total cholesterol and LDL-cholesterol levels, marital status, parenthood, living arrangements, education, employment and annual sick-leave days. After 1 and 5 years of GH replacement therapy, similar changes were evident with regard to body composition, fasting glucose and HbA1c levels, QoL, and the level of and satisfaction with physical activity across the three groups. Conclusions: Adults with untreated COCP with GHD at baseline demonstrated more co-morbidities including greater abnormalities of body composition, pituitary hormone deficits and visual field defects. Overall, adults with COCP, COH and COE tumours responded comparably to short-and long-term GH replacement therapy, suggesting that patients with GHD due to COCP benefited from GH replacement therapy to a similar degree as those with other causes of CO hypothalamic-pituitary dysfunction did.

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Section: Methodsmentioning

confidence: 99%

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Yuen

Kołtowska-Häggström

Cook³

et al. 2013

European Journal of Endocrinology

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“…The least impaired dimensions (problems with socializing and tenseness) tend to normalize earlier after initiating substitution therapy with recombinant human GH (rhGH) than self-confidence, tiredness and dissatisfaction with physical activity during leisure time, while the most affected dimensions (memory and concentration) are the last in improving (21). Additionally, rhGH-replaced AGHD patients reduce the use of healthcare resources (visits to doctor, days in hospital, sick leave and assistance with daily activities).…”

Section: Hypopituitarism (Including Growth Hormone Deficiency)mentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

Webb

Crespo

Santos

et al. 2017

European Journal of Endocrinology

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Background: In the last few years, quality of life (QoL) has become an outcome measure in patients with pituitary diseases. Objective: To describe the available data on QoL impairment evaluated with questionnaires in patients with pituitary diseases. Design: Critical review of the pertinent literature and pragmatic discussion of available information. Methods: Selection of relevant literature from PubMed and WOK, especially from the last 5 years and comprehensive analysis. Results: QoL is impaired in all pituitary diseases, mostly in acromegaly and Cushing's disease (similar to other causes of Cushing's syndrome), but also in non-functioning pituitary adenomas and prolactinomas, especially in the active phase of the disease. Nevertheless, even after endocrine 'cure', scores tend to be below normative values, indicative of residual morbidity after hormonal control. The presence of hypopituitarism worsens subjective QoL perception, which can improve after optimal substitution therapy, including recombinant human growth hormone, when indicated. Conclusions: To improve the long-term outcome of pituitary patients, helping them to attain the best possible health, it appears desirable to include subjective aspects captured when evaluating QoL, so that the affected dimensions are identified and if relevant treated. Additionally, being aware that treatment outcome may not always mean complete normalisation of physical and mental issues related to QoL can be a first step to adaptation and conforming to this new status.

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“…13,[75][76][77][78][79] Furthermore, patients also have improvements in sexual arousal and body shape after treatment, and have a very prompt improvement in dimensions of socialising and tenseness. 80,81 This information gives more support to the idea that patients could benefit from GH-substitution therapy.…”

Section: Non-functioning Pituitary Adenomasmentioning

confidence: 89%

Improving Quality of Life in Patients with Pituitary Tumours

Crespo¹,

Santos²,

Resmini³

et al. 2014

US Endocrinology

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Evaluation of health-related quality of life (QoL) in people with pituitary tumours has received much attention over the last 10-15 years. Most of them show impaired QoL, but little is known about how to prevent impairment or how to improve QoL. Our aim is to review what is known about QoL in pituitary tumours patients and to highlight the areas worth improving, for the patient's well being. The article has four sections: acromegaly, Cushing's syndrome, prolactinomas and non-functioning adenomas. Control of comorbidities is usually an important factor to prevent QoL impairment; however, each disease has specific characteristics that should be properly addressed in order to obtain full patient recovery after successful therapy.

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Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

Cited by 52 publications

References 67 publications

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

Improving Quality of Life in Patients with Pituitary Tumours

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