Endocrine Abstracts

Introduction: Patients with acromegaly are frequently left with long-term adverse sequelae. Cross-sectional evaluation of health-related quality of life (HR-QoL) using both generic and specific questionnaires (AcroQoL) has confirmed HR-QoL to be severely impaired in acromegaly. However, long-term HR-QoL outcomes following disease control have been less well-described.

Methods: The disease specific questionnaire AcroQoL and three validated generic questionnaires (the Psychological General Well-Being Schedule (PGWBS), the 36-item Short-Form (SF-36) health survey, and the EuroQol (EQ-5D)) were used to evaluate quality of life in 28 patients with acromegaly. Two sets of responses were obtained from each participant, within a time interval of minimum 5 years.

Results: Twenty-eight patients with acromegaly (male 46.4%, mean age at baseline 57.2±11.5 years) were assessed over a mean 5.68±0.6 years period, between baseline and follow-up responses. All patients had pituitary surgery, 57% required additional cranial radiotherapy and 50% medical treatment. Growth hormone levels at baseline and follow-up were 1.6±2.3 and 0.74±0.73 μg/l respectively (P=0.002), while IGF1 values were 102.4±63 and 105±52% of the upper limit of normal respectively (P=0.81). No difference in the scores of the AcroQoL (65.11±16.3 vs 66.11±19.1; P=0.66), PGWBS (66.29±20.9 vs 64.57±19.4; P=0.61), SF-36 (53.87±22.4% vs 48.96±23.9%; P=0.07), and EQ-5D (0.61±0.32 vs 0.55±0.32; P=0.32) were observed between baseline and follow-up responses. The physical domains of energy/fatigue, vitality, and bodily pain have been consistently the most under-marked areas in all questionnaires, in comparison with the psychological/emotional domains which were not as affected. The domain of physical function, in particular, was found to be significantly worse at follow-up compared with baseline, as assessed by the SF-36 (58.5±24.7% vs 43.1±31.1%; P=0.002).

Conclusions: Patients with acromegaly demonstrate impaired QoL which persists, despite long-term biochemical disease control. Physical limitations due to irreversible complications of acromegaly, such as arthropathy, appear to have the biggest impact on patients’ perceived quality of life.