Endocrine Abstracts

Advances in the treatment of acromegaly mean biochemical 'cure ' should be possible in the vast majority of patients. The challenge of the future will be designing treatment algorithms to optimise outcomes for individual patients, to ensure not only life expectancy but also QOL is normalised. QOL data is lacking in acromegaly, as is a disease-specific tool for measuring QOL. ACROQOL is a disease-specific QOL questionnaire compromising 22 questions (scored 1-5, high score good) developed in Spanish and translated to English. The questions cover physical and psychological aspects of the disease and are further sub-divided into 'appearance' and 'personal relations' categories. We have performed a cross-sectional study of QOL in 54 patients (23 male, mean age 55 years, range 20-84) with acromegaly of varying severity (median GH 3.1 mmol/l range <1-49.5, IGF-I 318.4 ng/ml, range 47.7 - 899). Patients completed 3 QOL questionnaires: Psychological General Well-Being Schedule (PGWBS) (22 questions, scored 0-5, 6 subsets, high score good), a Signs and Symptoms score (SSS) accessing fatigue, sweating, headache, arthralgia, sweating & perception of soft tissues swelling (each scored 0 - 8 high score bad) and ACROQOL. All three questionnaires confirmed confirm impairment in QOL, mean scores: PGWBS 68.8, ACROQOL 58.3%, SSS 11.6, with 'vitality' being the lowest scoring subset in PGWBS. There was no correlation between biochemical control and any measure of QOL. ACROQOL correlated with PGWBS (r = 0.63, P <0.0007) and in patients with active disease ACROQOL-physical dimension correlated with SSS (r=-0.72, P <0.0003). In conclusion, these data underline the marked impact that acromegaly has on patients' QOL and provide the first evidence validating ACROQOL against a well-authenticated measure of QOL. It indicates the potential of ACRQOL as a patient-friendly measure of disease activity. Prospective studies of change in ACROQOL with treatment are awaited.