Surgically treated acromegaly patients have a similar quality of life whether controlled by surgery or requiring additional medical therapy (QuaLAT Study)

Abstract

Purpose There is no consensus on quality of life (QOL) in patients with acromegaly requiring medical treatment after surgery compared with those achieving remission by surgery alone. Methods QuaLAT is a cross-sectional study comparing QOL in surgery-only treated acromegaly patients versus those requiring medical treatment post-surgery. Patients attending clinics were identified and divided into—Group 1: patients who had surgery only and were in biochemical remission, Group 2: all patients on medical treatment post-surgery, Group 3: patients from Group 2 with biochemical control. Participants were asked to fill three questionnaires; Acromegaly Quality of Life Questionnaire (ACROQOL), 36-Item Short Form Survey (SF36), and Fatigue Severity Scale (FSS). Results There were 32 patients in Group 1 and 25 in Group 2. There was no difference in QOL scores between groups 1 and 2, as measured by ACROQOL (mean difference [MD] = − 2.5, 95% CI − 16.6 to 11.6; p = 0.72), SF36v2 [Physical component score (PCS) MD = − 4.9, 95% CI − 10.9 to 1.2; p = 0.12; mental component score MD = − 3.0, 95% CI − 10.5 to 4.4; p = 0.44], or FSS (MD = − 0.004, 95% CI − 1.14 to 1.33; p = 0.1). Comparison between groups 1 and 3 however showed that PCS (and 3 subdomains) was significantly better in group 3 (MD = − 8.3, 95% CI − 14.8 to -1.8; p = 0.01). All three QOL scores were lower when compared with healthy controls. Conclusions Medical treatment not only achieves a QOL comparable to surgery, it may also be associated with better QOL in physical subdomains. When compared with healthy controls, QOL remains worse in treated acromegaly patients compared to controls.

Reporting of Participants' Sex, Race, Ethnicity, and Socioeconomic Status in Pituitary Surgery Literature

“…Little et al was the only paper to include a complete racial and ethnic distribution of all 113 participants. 17 One additional paper (Arshad et al 18 ) noted that information on ethnicity was collected, but that data were not reported in the printed publication. ►Fig.…”

Cardiovascular Effects of Excess Growth Hormone: How Real is the Threat?

“…Other available options include medical and radiotherapy. However, despite the multiple options for treatment, approximately 40% of patients remain uncontrolled [ 77 ]; and more importantly, regardless of biochemical control, health-related quality of life remains unimproved [ 78 ]. There is often a delay in treatment owing to delayed diagnosis as well, as symptom development in acromegaly can take years [ 79 ].…”

“…As such, studies are looking into innovations in treatment to a precision medicine which can direct treatment in a more individualized approach. Moreover, new drugs for acromegaly are being developed, with potential to further improve disease control [ 78 ]. Lastly, attempts at earlier diagnosis and treatment can decrease progression of disease and its associated comorbidities.…”