Quality of Life in Acromegaly

Webb, Susan M.

doi:10.1159/000095532

Cited by 57 publications

(49 citation statements)

References 20 publications

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“…This is the first study to report on the use of AcroQoL in a nationwide registry with controlled and uncontrolled patients. Median AcroQoL total and subscores are comparable with those reported earlier for acromegalic patients in remission (5,7,14,20,21), and higher than that in active acromegaly (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionsupporting

confidence: 82%

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Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian Registry on acromegaly

et al. 2007

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Objective: To assess the impairment of quality of life (QoL), evaluated by the acromegaly QoL (AcroQoL) questionnaire, in patients with controlled and uncontrolled acromegaly. Design: Cross-sectional evaluation of AcroBel, a national observational registry of acromegalic patients newly diagnosed or in follow-up. Methods: Disease perception by the patients was evaluated by the disease-specific signs and symptoms score (SSS) and QoL was assessed by the AcroQoL questionnaire. Hormonal status was determined by central measurements of GH and IGF-I. Results: Patients (nZ291) had a median GH of 1.43 mg/l (0.65-3.03; IQR), a median IGF-I of 231 mg/l (150-367), and a mean IGF-I z-score of C1.91 (S.D. 2.21). The AcroQoL total score in the whole group was 67.1 (51.1-78.4), with a score of 65.6 (43.8-78

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Section: Discussionsupporting

confidence: 82%

“…Variability of HRQoL over time is not taken into account, because of the cross-sectional nature of the design. Recently, published data, however, confirm a good test-retest reliability of the AcroQoL (13).…”

Section: Discussionmentioning

confidence: 96%

Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian Registry on acromegaly

et al. 2007

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“…The observation made from that study, which did not include patients on medical treatment, was replicated in our population, and both dataset suggest that additional factors such as abdominal adiposity may contribute to the relative increase in GH levels in females as compared with males (46). It is generally appreciated that health-related quality of life is impaired in acromegaly, and that this impairment is only partially restored following treatment (47)(48)(49). It was, however, unexpected that the disease-specific health status of SA-treated patients was significantly poorer as compared with patients treated only with surgery.…”

Section: Discussionsupporting

confidence: 58%

Conventional and novel biomarkers of treatment outcome in patients with acromegaly: discordant results after somatostatin analog treatment compared with surgery

Rubeck

Madsen²,

Andreasen³

et al. 2010

European Journal of Endocrinology

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Context: Control of disease activity in acromegaly is critical, but the biochemical definitions remain controversial. Objective: To compare traditional and novel biomarkers and health status in patients with acromegaly treated with either surgery alone or somatostatin analog (SA). Design and methods: Sixty-three patients in long-term remission based on normalized total IGF1 levels after surgery alone (nZ36) or SA (nZ27) were studied in a cross-sectional manner. The groups were comparable at diagnosis regarding demographic and biochemical variables. Each subject underwent 3 h of serum sampling including a 2-h oral glucose tolerance test (OGTT). Health status was measured by two questionnaires: EuroQoL and Acrostudy (Patient-assessed-Acromegaly symptom questionnaire (PASQ)). Results: Total and bioactive IGF1 (mg/l) levels were similar (total: 185G10 (SA) versus 171G8 (surgery) (PZ0.28); bioactive: 1.9G0.2 vs 1.9G0.1 (PZ0.70)). Suppression of total and free GH (mg/l) during OGTT was blunted in the SA group (total GH nadir : 0.59G0.08 (SA) versus 0.34G0.06 (surgery) (PZ0.01); free GH nadir : 0.43G0.06 vs 0.19G0.04 (P!0.01)). The insulin response to OGTT was delayed, and the 2-h glucose level was elevated during SA treatment (PZ0.02). Disease-specific health status was better in patients after surgery (PZ0.02). Conclusions: i) Despite similar and normalized IGF1 levels, SA treatment compared with surgery alone was associated with less suppressed GH levels and less symptom relief; ii) this discordance may be due to specific suppression of hepatic IGF1 production by SA; iii) we suggest that biochemical assessment during SA treatment should include both GH and IGF1.

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“…Biochemical control is associated with a lower prevalence of DM (Reimondo et al 2014), partial improvement of the cardiac dysfunction and increase in the cardiac performance (Mosca et al 2013). Hypertension, valvulopathy (Colao et al 2004), sleep apnea (Roemmler et al 2012), joint complaints and related decrease in QoL (Biermasz et al 2005) and overall affected QoL (Webb 2006) persist in a high percentage of patients with even controlled disease. The increased mortality associated with active, persistent disease returns to expected values in cured patients, while persistent disease is still associated with a SMR of 1.8 (Swearingen et al 1998).…”

Section: Long-term Results Of the Treatmentmentioning

confidence: 99%

“…As a consequence of the multiple comorbidities and the somatic changes, ACM patients have severely impaired QoL (Webb 2006), psychological impairment, increased anxiety and decreased self-esteem (Pantanetti et al 2002).…”

Section: Complicationsmentioning

confidence: 99%

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

Căpățînă¹,

Wass²

2015

Journal of Endocrinology

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Acromegaly (ACM) is a chronic, progressive disorder caused by the persistent hypersecretion of GH, in the vast majority of cases secreted by a pituitary adenoma. The consequent increase in IGF1 (a GH-induced liver protein) is responsible for most clinical features and for the systemic complications associated with increased mortality. The clinical diagnosis, based on symptoms related to GH excess or the presence of a pituitary mass, is often delayed many years because of the slow progression of the disease. Initial testing relies on measuring the serum IGF1 concentration. The oral glucose tolerance test with concomitant GH measurement is the gold-standard diagnostic test. The therapeutic options for ACM are surgery, medical treatment, and radiotherapy (RT). The outcome of surgery is very good for microadenomas (80-90% cure rate), but at least half of the macroadenomas (most frequently encountered in ACM patients) are not cured surgically. Somatostatin analogs are mainly indicated after surgical failure. Currently their routine use as primary therapy is not recommended. Dopamine agonists are useful in a minority of cases. Pegvisomant is indicated for patients refractory to surgery and other medical treatments. RT is employed sparingly, in cases of persistent disease activity despite other treatments, due to its long-term side effects. With complex, combined treatment, at least three-quarters of the cases are controlled according to current criteria. With proper control of the disease, the specific complications are partially improved and the mortality rate is close to that of the background population.

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Quality of Life in Acromegaly

Cited by 57 publications

References 20 publications

Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian Registry on acromegaly

Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian Registry on acromegaly

Conventional and novel biomarkers of treatment outcome in patients with acromegaly: discordant results after somatostatin analog treatment compared with surgery

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

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