The effect of treatment on quality of life in patients with acromegaly: a prospective study

Abstract

Objective Acromegaly has a negative influence on health-related quality of life (HRQoL). Previous studies provide limited information on the course of HRQoL during treatment. This study aims to assess the effect of treatment on the course of HRQoL at six predefined time points. Design This prospective study examines HRQoL in treatment-naive patients before and during the first 2.5 years of acromegaly treatment. Methods Therapy-naive acromegaly patients completed three validated questionnaires (RAND-36, AcroQoL, and the Appearance Self-Esteem (ASE)) at six predetermined time points before, during, and after treatment. Outcomes were correlated to IGF1 levels and disease control status. Results Twenty-seven acromegaly patients completed the questionnaires at all time points. After treatment, all patients had controlled acromegaly. Scores of RAND-36 domains General health, Vitality and Health change, and all AcroQoL dimensions (except for Relations) improved during treatment (P ≤ 0.003); the largest changes were detected during the first year. Gender influenced HRQoL scores, since AcroQoL scores significantly improved in males but not in females. Over time, IGF1 levels were negatively correlated with HRQoL. After 2.5 years of follow-up, HRQoL of controlled patients was still lower than in the general population. Conclusion HRQoL of acromegaly patients was considerably reduced at diagnosis. Disease control was associated with an improvement of HRQoL scores. Males showed a more pronounced improvement than females. The largest changes were detected in the first year of treatment. However, HRQoL during and after treatment remained impaired in acromegaly patients, emphasizing the need of additional support.

A Pituitary Society update to acromegaly management guidelines

“…Other studies confirmed beneficial effects of acromegaly treatment on health-related quality of life (QOL). QOL improved but did not normalize in a prospective study of 27 patients followed for 2.5 years after diagnosis, all of whom achieved disease control with surgery and/or medical therapy, especially in the first year of treatment [32]. Results of the longitudinal surveillance ACROSTUDY similarly showed improvement in QOL with pegvisomant using both AcroQoL and PASQ questionnaires [33].…”

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

“…Other predictors have been inconsistently identified; longer disease duration, painful syndrome (musculoskeletal or headache), diabetes, older age, female gender, having received treatment with radiotherapy, and becoming GH-deficient after treatment 75 , 102 , 103 . Successful therapy might improve QoL but may not normalize QoL completely, even after biochemical cure 75 , 104 – 107 . Indeed, QoL has been shown to be severely impaired years after successful treatment in patients with acromegaly compared with the general population 104 , 108 , 109 .…”

“…Successful therapy might improve QoL but may not normalize QoL completely, even after biochemical cure 75 , 104 – 107 . Indeed, QoL has been shown to be severely impaired years after successful treatment in patients with acromegaly compared with the general population 104 , 108 , 109 .…”

Differences in quality of life between genders in acromegaly

“…Although numerous QoL measurement instruments have been developed, the Acromegaly Quality of Life Questionnaire (AcroQoL) addresses some specific items regarding disease progression and treatment outcomes 4 . Several factors have been identified as impacting QoL in acromegaly, including depression, body mass index (BMI), 5 body image, general psychopathology, pain, comorbidities and type of treatment 6,7 . Biochemical markers of treatment outcomes have not been consistently associated with a change in QoL scores.…”

“…4 Several factors have been identified as impacting QoL in acromegaly, including depression, body mass index (BMI), 5 body image, general psychopathology, pain, comorbidities and type of treatment. 6,7 Biochemical markers of treatment outcomes have not been consistently associated with a change in QoL scores. Overall, the results of most studies regarding predictors of QoL in acromegaly are ambiguous or insufficient.…”