Characterisation of the acromegalic arthropathy in patients <50 years of age

Nikolaos Kyriakakis; Megan Heague; Sophie Hebden; Nawaz Safdar; McLaren David S.; Tresoldi Alberto S.; Lithgow Kirstie; Urwyler Sandrine; Chetna Varsani; Akbar Shahzad; McLoughlin Katie; Katarzyna Adeniji; Tara Kearney; Drake William M.; Thozhukat Sathyapalan; Higham Claire E.; Niki Karavitaki; Julie Lynch; Murray Robert D.

doi:10.1530/endoabs.109.OP1.1

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Endocrine Abstracts (2025) 109 OP1.1 | DOI: 10.1530/endoabs.109.OP1.1

SFEBES2025 Poster Oral Presentations Neuroendocrinology and Pituitary (4 abstracts)

Characterisation of the acromegalic arthropathy in patients <50 years of age

Nikolaos Kyriakakis ¹ , Megan Heague ¹ , Sophie Hebden ¹ , Nawaz Safdar ¹ , David S. McLaren ¹ , Alberto S. Tresoldi ² , Lithgow Kirstie ² , Urwyler Sandrine ² , Chetna Varsani ³ , Akbar Shahzad ⁴ , McLoughlin Katie ⁵ , Katarzyna Adeniji ⁵ , Tara Kearney ⁵ , William M. Drake ³ , Thozhukat Sathyapalan ⁴ , Claire E. Higham ⁶ , Niki Karavitaki ² , Julie Lynch ¹ & Robert D. Murray ¹

Author affiliations

¹Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; ²University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; ³St Bartholomew’s Hospital, London, United Kingdom; ⁴Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom; ⁵Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom; ⁶The Christie NHS Foundation Trust, Manchester, United Kingdom

Background: The acromegalic arthropathy is a disease-specific, progressive, degenerative arthropathy. Degenerative arthropathies such as osteoarthritis are infrequent below the age of 50 years. We characterised the prevalence of acromegalic arthropathy in patients <50 years of age.

Methods: We undertook a multicentre, cross-sectional study, utilising validated questionnaires in patients with acromegaly, aiming to examine distribution of arthropathy, severity of pain, and treatment modalities employed.

Results: Of the total cohort, 107/411 patients were <50 years of age (median 41, 18-50 years; 47F; 44.9% with active disease) and 304 were >50 years (median 65, 51-88 years; 163F; 35.5% with active disease). The most painful joint was similar to the overall cohort (lower back [20.8%], knees [16.0%] and hips [12.3%]). The median number of painful joints was 5 (range 0-25). 36.4% and 10.3% of those <50 years complained of moderate or severe joint pain respectively, compared with 45.7% and 14.1% of those >50 years. 56% and 29.9% of patients aged <50 years were taking at least one or two regular analgesics respectively, whereas the corresponding percentages for those >50 years were 61.4% and 37.2%. The most frequently used analgesics in patients aged ≤50 years were paracetamol (39.3%), oral non-steroidal anti-inflammatory drugs (NSAIDs; 29.9%), topical NSAIDs (9.3%), and codeine (15.0%). Four individuals were taking more potent opioids and 6 atypical analgesics. 16.8% of these patients had received at least one joint injection, however only three patients (2.8%) had undergone joint replacement therapy for a total of five joints (2 shoulders, 2 hips and 1 knee). In those aged >50 years 29.9% had received at least one joint injection and 22.0% (n = 67/304) had at least one joint replaced.

Conclusions: Patients with acromegaly aged <50 years have significant arthropathy burden characterised by pain, requirement for analgesics and joint injections, however joint replacement was uncommon.