Endocrine Abstracts

Background: The goals of acromegaly treatment are to achieve long-term biochemical control, control tumor size and decrease the risk of developing systemic comorbidities. Moreover, from the patient’s perspective, symptoms and QoL are critical parameters of disease control and should be assessed routinely. To aid in the global clinical management of acromegaly, a holistic clinical decision support tool, the Acromegaly Disease Activity Tool (ACRODAT®) was developed.

Objectives: To describe and analyze the acromegaly disease activity according to ACRODAT®.

Methods: Observational, cross-sectional study conducted in a Spanish tertiary hospital (Hospital General Universitario Gregorio Marañón). The ACRODAT® tool was used to assess disease activity entering the data collected in the study.

Results: In total, 42 acromegaly patients were enrolled. 26 patients were female (61.9%). The average age was 59.66 years (SD 15.22), the BMI was 31.85 Kg/m² (SD 20.53), % body fat mass was 36.93 (7.52), % truncal fat mass was 36.93 (7.52). IGF-1 levels were within normal limits in 64,3% of patients, between ULN and 1.2xULN in 21.4% of patients and >1.2 ULN in the 14.3% of patients. 100% of patients showed a stable tumor size. The most frequent comorbidity was cardiac disease (57.14%), followed by sleep apnea (40.48%) and diabetes (35.71%). According to ACRODAT®, 61.9% (n=26) of patients were classified as stable (S), 23.8% (n=10) as having mild disease activity (M-DA) and 14.3% (n=6) as having significant disease activity (S-DA). 100% of S-DA patients showed IGF-1 levels >1.2ULN, 83.3% suffered from cardiac disease (n=5), 50% from diabetes (n=3) and 16.7% from sleep apnea (n=1). 66.7% (n=4) of S-DA patients showed not-controlled comorbidities, 50% (n=3) poor controlled of the symptomatology and 16.7% (n=1) poor QoL. In the total cohort of patients, in terms of comorbidities, patients were classified as controlled in 33.3% of patients, partially controlled in 33.33% of patients (n=14) and not controlled in 30.2% (n=13). Symptomatology was classified as stable in 31% of cases (n=14), 55.8% of cases (n=24) as mild activity and 9.3% of the patients (n=4) as significant disease. 58.1% of patients showed minimal or no impairment of QoL, mild impairment in 25.6% of patients and 14% with significant impairment.

Conclusions: ACRODAT® is a validated tool to monitor acromegaly disease activity that incorporates patient-centric parameters such as QoL and symptomatology.