Quality of life after long-term biochemical control of acromegaly

• Published in: Pituitary Vol. 25; no. 3; pp. 531 - 539
• Main Authors: Kimball, Allison, Dichtel, Laura E., Yuen, Kevin C. J., Woodmansee, Whitney W., Haines, Melanie S., Nachtigall, Lisa B., Swearingen, Brooke, Jones, Pamela, Tritos, Nicholas A., Sharpless, Julie L., Kaiser, Ursula B., Gerweck, Anu, Miller, Karen K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2022; Springer Nature B.V
• Subjects: Acromegaly; Acromegaly - drug therapy; Adult; Cross-Sectional Studies; Drug therapy; Endocrinology; Growth hormone; Growth Hormone - therapeutic use; Growth hormones; Human Physiology; Humans; Medicine; Medicine & Public Health; Patients; Quality of Life; Questionnaires; Radiation therapy; Surveys and Questionnaires; Acromegaly; Radiation therapy; Growth hormone deficiency; Quality of life
• ISSN: 1386-341X; 1573-7403
• DOI: 10.1007/s11102-022-01224-0

Purpose To assess long-term quality of life (QoL) in patients with sustained biochemical control of acromegaly, comparing those receiving vs not receiving pharmacotherapy (primary analysis); to assess change in QoL over time (secondary analysis). Methods Cross-sectional study, with a secondary longitudinal component, of 58 patients with biochemically controlled acromegaly. All had participated in studies assessing QoL years previously, after having undergone surgery ± radiotherapy. One cohort received medical therapy [MED (n = 33)]; the other did not [NO-MED (n = 25)]. QoL was assessed by the 36-Item-Short-Form Health Survey (SF-36), Acromegaly Quality of Life Questionnaire (AcroQoL), Gastrointestinal Quality of Life Index (GIQLI), Symptom Questionnaire, and QoL-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA). Results Mean (± SD) duration of biochemical control was 15.0 ± 6.4 years for MED and 20.4 ± 8.2 years for NO-MED (p = 0.007). 58% of subjects scored < 25% of normal on ≥ 1 SF-36 domain and 32% scored < 25% of normal on ≥ 4 of 8 domains. Comparing MED vs NO-MED and controlling for duration of biochemical control, there were no significant differences in QoL by SF-36, AcroQOL, GIQLI, Symptom Questionnaire, or QoL-AGHDA. Growth hormone deficiency (GHD) but not radiotherapy predicted poorer QoL. In MED, QoL improved over time in three AcroQoL domains and two GIQLI domains. In NO-MED, QoL worsened in two SF-36 domains and two Symptom Questionnaire domains; QoL-AGHDA scores also worsened in subjects with GHD. Conclusion A history of acromegaly and development of GHD, but not pharmacologic or radiotherapy, are detrimental to QoL, which remains poor over the long-term despite biochemical control.