Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity

Fatti, Letizia Maria; Cangiano, Biagio; Persani, Luca; Mantovani, Giovanna; Sala, Elisa; Arosio, Maura; Maffei, Pietro; Dassiè, Francesca; Mormando, Marilda; Giampietro, Antonella; Tanda, Maria Laura; Masiello, E.; Nazzari, Elena; Ferone, Diego; Corbetta, Serafino; Passeri, Elena; Guaraldi, Federica; Grottoli, Silvia; Cannavò, Salvatore; Torre, Maria Luisa; Soranna, Davide; Zambon, Antonella; Cavagnini, Francesco; Scacchi, Massimo

doi:10.1007/s11102-019-00966-8

Cited by 25 publications

(29 citation statements)

References 31 publications

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“…The conclusion was that patients with acromegaly had a significantly higher number of musculoskeletal problems that negatively affect their QoL at different levels 136 . Female patients and those with higher BMI seem to be the most affected 137 . In regard to vertebral fractures, no definite association has been observed with QoL; this is probably because many events are asymptomatic and many are missed unless patients had vertebral x-ray rather than bone densitometry 138 .…”

Section: Quality Of Lifementioning

confidence: 98%

Updates in rare and not-so-rare complications of acromegaly: focus on respiratory function and quality of life in acromegaly

2020

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Acromegaly is a complex disease with excessive growth hormone and insulin-like growth factor 1 (IGF-1) causing multisystem effects, particularly cardiovascular, respiratory, and metabolic. Psychological concerns and poor quality of life (QoL) are also major disease consequences. This review is intended for clinicians and focuses on the latest developments related to respiratory and QoL effects of long-term growth hormone excess. Along with biochemical disease control, patient treatment satisfaction and outcomes have become major treatment objectives; current knowledge and tools to evaluate and manage this aspect of the disease are described. Sleep apnea syndrome and other derangements of lung function and apparatus, from pathophysiology to treatment, and evaluation tools and determinants of QoL in patients with acromegaly are discussed.

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Section: Quality Of Lifementioning

confidence: 98%

Updates in rare and not-so-rare complications of acromegaly: focus on respiratory function and quality of life in acromegaly

2020

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“…Despite fertility impairment due to the mass effect of macroadenoma, hyperprolactinemia, or hyperandrogenism, pregnancy is increasingly reported in female acromegaly patients, owing to the improved efficacy of treatments for acromegaly and infertility [ 84 ].…”

Section: Clinical Issuesmentioning

confidence: 99%

“…Scientific insights into this crucial event in a woman’s life have recently been reported and pregnancy is generally considered safe [ 84 - 89 ]. Large tumors and/or those close to optic pathways should be resected by a skilled neurosurgeon in order to improve fertility and prevent pituitary enlargement (and possible apoplexy) during pregnancy.…”

Section: Clinical Issuesmentioning

confidence: 99%

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Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Cozzi

Ambrosio

Attanasio

et al. 2020

EMIDDT

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: Acromegaly is a rare disease. Improvements in lifespan in these patients have recently been reported due to transsphenoidal surgery (TSS), advances in medical therapy, and tighter criteria for defining disease remission. This document reports the opinions of a group of Italian experts who have gathered together their prolonged clinical experience in the diagnostic and therapeutic challenges of acromegaly patients. Both GH and IGF-I (only IGF-I in those treated with Pegvisomant - PegV) are needed in the diagnosis and follow-up. Comorbidities (cardio-cerebrovascular disease, sleep apnea, metabolic derangement, neoplasms, and bone/joint disease) should be specifically addressed. Any newly diagnosed patient should be referred to a multidisciplinary team experienced in the treatment of pituitary adenomas.

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“…Noteworthy, VFs were found to develop even in patients with normal BMD [13, 17], making uncertain the diagnostic and therapeutic management of skeletal fragility in this clinical setting [18, 19]. Moreover, the clinical impact of VFs in acromegaly is unknown [20, 21], and it is still uncertain whether a relationship may exist between arthropathy and skeletal fragility in this clinical setting [22].…”

Section: Introductionmentioning

confidence: 99%

Vertebral Fractures Associated with Spinal Sagittal Imbalance and Quality of Life in Acromegaly: A Radiographic Study with EOS 2D/3D Technology

Cellini¹,

Biamonte²,

Mazza³

et al. 2020

Neuroendocrinology

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Introduction: Acromegaly is commonly complicated by arthropathy and skeletal fragility with high risk of vertebral fractures (VFs). Objective: This study aimed to assess whether VFs may be associated with sagittal spine deformities, arthropathy, impaired quality of life (QoL), pain, and disability. Methods: Thirty-eight patients with acromegaly (median age: 55 years, 20 males) and 38 matched control subjects were evaluated by a low-dose sagittal and coronal planes, X-ray imaging system (EOS®-2D/3D) for morphometric VFs, radiological signs of spine arthropathy, and spine deformities (Cobb thoracic index ≥40°, pelvic incidence minus lumbar lordosis ≥10°, pelvic tilt >20°, and sagittal vertical axis ≥4 cm) determining sagittal spine imbalance. Acromegalic patients were also evaluated by questionnaires for QoL (Acromegaly QoL Questionnaire [AcroQoL] and Short Form-36 [SF-36]) and pain and disability (Western Ontario and McMaster University [WOMAC]). Results: Acromegalic patients showed higher prevalence of thoracic hyperkyphosis (i.e., Cobb thoracic index ≥40°; p = 0.04) and pelvic tilt >20° (p = 0.02) than control subjects. VFs were found in 34.2% of acromegalic patients (p = 0.003 vs. control subjects), in relationship with higher prevalence of hyperkyphosis (p = 0.03), pelvic tilt >20° (p = 0.04), sagittal vertical axis ≥4 cm (p = 0.03), and moderate/severe subchondral degeneration (p = 0.01). Moreover, patients with VFs had lower AcroQoL general health (p = 0.007) and SF-36 general health (p = 0.002) scores and higher WOMAC pain (p = 0.003) and global (p = 0.009) scores than patients who did not fracture. Conclusions: In acromegaly, VFs may be associated with spine deformities and sagittal imbalance, spine arthropathy, impaired QoL, and disability.

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Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity

Cited by 25 publications

References 31 publications

Updates in rare and not-so-rare complications of acromegaly: focus on respiratory function and quality of life in acromegaly

Updates in rare and not-so-rare complications of acromegaly: focus on respiratory function and quality of life in acromegaly

Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Vertebral Fractures Associated with Spinal Sagittal Imbalance and Quality of Life in Acromegaly: A Radiographic Study with EOS 2D/3D Technology

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