Endocrine Abstracts

Active acromegaly is associated with considerable morbidity and increased mortality. Multimodality treatment of acromegaly is nowadays effective in the vast majority of patients and consequently survival of acromegaly has improved/normalized.

Nevertheless, significant chronic physical and psychological complaints persist in the long-term follow-up after cure of acromegaly and quality of life in patients has reported to remain significantly reduced despite biochemical cure.

The definition of biochemical cure can be subject to debate and is largely dependent on the used assay. The long-term outcome of patients with ‘cured’ acromegaly is described, i.e. the global health status of patients with a special focus on the most prevalent invalidating sequelae of acromegaly on the skeleton, i.e. acromegalic arthropathy and vertebral fractures. The main factors of influence of severity of joint disease and progression appears to be the severity of GH excess prior to diagnosis, but also current GH/IGFI levels and other potential modifiable factors have been suggested. Quality of life is dependent on joint disease, but also psychological factors, i.e. depression scores determine the perceived severity of joint disease.

Patient perception of disease increasingly receives attention and was recently studied with existing questionnaires, but also with qualitative health research using focus groups. Results will be discussed in the context of available quality of life studies.

In conclusion, despite biochemical cure, many patients suffer from complications of acromegaly, and an optimal care model will require a multidisciplinary approach, including physiotherapist, and psychologists.