Endocrine Abstracts

Introduction: Patients with acromegaly are frequently left with long-term adverse sequelae. When compared with individuals with other pituitary adenomas, patients with acromegaly demonstrate greater impairment in their quality of life (QoL).

Methods: The disease-specific questionnaire, AcroQoL, and the generic psychological general well-being schedule (PGWBS) were used to evaluate QoL in an acromegaly patient cohort. Longitudinal data were also collected to determine change in QoL over a 5-year period.

Results: Baseline responses were collected from 58 patients (age 55.1±13.0 years). For the entire cohort, mean GH and IGF1 values at baseline were 1.53±2.07 μg/l and 102.1±51% of the upper limit of normal (ULN) respectively. Mean duration of GH control (GH <2 μg/l) was 5.4±4.8 years, whereas for IGF1 this was 4.4±4.3 years. Follow-up responses were obtained from 23 patients (age 55.6±10.0 years). For this subgroup, mean GH and IGF1 at follow-up were 0.76±0.75 μg/l and 110.4±54.3% of ULN respectively (vs 1.6±2.4 μg/l and 110.5±64.7% of ULN at baseline). The mean total score for AcroQoL at baseline was 67.8±18.4 (48.0%). The domain of appearance was the most under-marked, while the highest scores were noted in the personal relationships domain. For the subgroup of 23 patients, no significant difference was found in the baseline and follow-up AcroQoL scores (64.2 vs 65.7, P=0.58). PGWBS scores were significantly lower in the patient group compared with reference population, both at baseline (median score 71.5 (IQR 52.0–86.5) vs 89.5 (IQR 81.0–95.75), P<0.001) and follow-up (median score 61.0 (IQR 46.0–83.0) vs 89.5 (IQR 81.0–95.75), P<0.001). Baseline and follow-up PGWBS scores were not statistically different for the subgroup of 23 patients. Positive well-being, general health and vitality were the mostly under-marked domains.

Conclusion: Our results demonstrate impairment of QoL in acromegaly, which fails to improve despite long-term disease control. A more holistic approach, potentially in a multi-disciplinary setting involving clinical psychologists, should be implemented.