ECE2024 Poster Presentations Late-Breaking (77 abstracts)
The prevalence, distribution and use of analgesics for arthropathy in patients with acromegaly
Megan Heague 1 , Sophie Hebden 1 , Julie Lynch 2 , Nawaz Z Safdar 2 , David McLaren 2,3 , Alberto Stefano Tresoldi 4,5,6 , Sandrine Urwyler 4,5,6 , Kirstie Lithgow 4,5,6 , Chetna Varsani 7 , Shahzad Akbar 8 , Katie McLoughlin 9 , Katarzyna Adeniji 9 , Tara Kearney 9 , Thozhukat Sathyapalan 8 , Claire Higham 10 , William Drake 7 , Niki Karavitaki 4,5,6 , Robert D Murray 2,3 & Nikolaos Kyriakakis 2
1University of Leeds, School of Medicine, Leeds, United Kingdom; 2Leeds Teaching Hospitals NHS Trust, Department of Endocrinology, Leeds, United Kingdom; 3University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), Leeds, United Kingdom; 4University of Birmingham, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, Birmingham, United Kingdom; 5Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom; 6University Hospitals Birmingham NHS Foundation Trust, Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom; 7Barts Health NHS Trust, Department of Endocrinology, St Bartholomew’s Hospital, London, United Kingdom; 8Hull University Teaching Hospitals NHS Trust, Department of Academic Diabetes and Endocrinology, Hull, United Kingdom; 9Salford Royal NHS Foundation Trust, Department of Endocrinology, Salford, United Kingdom; 10The Christie NHS Foundation Trust, Department of Endocrinology, Manchester, United Kingdom
Background: Despite biochemical control of GH and IGF-I levels patients with acromegaly continue to have marked impairment of their well-being. The acromegalic arthropathy has been identified as a significant contributor to the impaired well-being of these individuals. We aimed to establish the true prevalence of arthropathy, distribution of joint involvement and use of analgesics for arthropathy in a large series of patients with acromegaly.
Methods: Patients with a diagnosis of acromegaly under follow-up in six tertiary pituitary centres were invited to complete a questionnaire relating to joint pain and distribution; management of their joint problems when present; and impact on function and QoL. We present data from the ‘joint pain human figure’ describing involved joints; ‘joint pain scale’; and ‘medication usage’ questionnaires.
Results: 411 patients completed the questionnaires, median age 60 (range 18-88) yrs, 56.1% female and mean age at diagnosis 43 (range 12-83) yrs. 338 (82.2%) patients reported joint, back or neck pain of >6 weeks duration within the preceding 3 months. The median number of joint sites affected was 4 (range 0-14), and median number of joints affected 5 (range 0–25). The most frequently involved individual joint was the knee (n=225; 57.1%), lower back (196; n=49.7%), hip (n=160; 40.6%) and shoulder (n=159; 40.4%). The most painful joint was reported to occur most frequently within the large joints (n=218), compared with the axial skeleton (n=133) and small joints (n=73). Similar to the involved joints, the single ‘most painful’ individual joint was reported as the knee (n=86; 21.8%), lower back (n=86; 21.8%) or hip (n=55; 14.0%). On a scale of 0-10, severity of pain occurring during the preceding week was rated at a median of 4 (range 0-10). 52 patients had no pain (13.1%; score 0), 114 mild pain (28.6%; score 1-3), 178 moderate pain (44.7%; score 4-7) and 54 severe pain (13.6%; score 8-10). 247 (61.4%) patients documented taking regular analgesics for joint pain. 173 used paracetamol, 110 oral non-steroidal anti-inflammatory drugs (NSAIDS), 64 topical NSAIDS, 65 codeine and 47 potent opioids or atypical analgesics (i.e amitriptyline, pregabalin). A single analgesic was used by 110 individuals; and two or more agents by 137. Most individuals taking two or more analgesics took a combination of paracetamol with an oral / topical NSAID.
Conclusion: Patients with a diagnosis of acromegaly have a significant arthropathy burden, frequently involving multiple joints and necessitating use of regular analgesics and anti-inflammatory agents.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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