Endocrine Abstracts

Introduction: Cushing’s syndrome (CS) has been associated with low quality of life, even after biochemical cure. However little data is available on long term follow-up. The aim of the study was to analyse 10-year follow-up of quality of life (QoL) in patients in remission of CS.

Methods: 24 patients in remission of CS followed in Hospital Sant Pau were included in this study (3 men, 21 pituitary origin, 3 adrenal; mean baseline age 45.1 ± 14.1). They performed their yearly clinical follow-up visits (including clinical and analytical parameters) and the same day completed 2 QoL questionnaires (EuroQoL and CushingQoL). This was performed both basally (at least one year after cure) and after 10 years ( ± 6 months).

Results: After 10 years, a decrease in QoL was found. Mean CushingQoL scores at first evaluation were 64, vs 58 after 10 years (P <0.001, scores worsened in 70.8% of the patients), while for EuroQoL-VAS basal scores were 73 vs 64 after 10 years (P = 0.002, scores worsened in 58.3% of the patients). Two patients had a recurrence at 10 year follow-up, but results did not change when both patients were excluded from the analysis (P < 0.001 for both questionnaires). The percentage of patients reporting problems in the 5 dimensions of EuroQoL at both evaluations was: mobility (28% vs 40%), self-care (12% vs 20%), usual activities (32% vs 32%), pain/discomfort (52% vs 64%), and anxiety/depression (44% vs 52%). CushingQoL and EuroQoL-VAS scores after 10 years correlated with baseline scores (CushingQoL P = 0.003, R = 0.586; EuroQoL-VAS P = 0.002, R = 0.605), but did not correlate with diagnostic delay, time since surgery, current urinary free cortisol, plasma cortisol, late-night salivary cortisol, ACTH, blood pressure, BMI or age.

Conclusion: QoL in patients in remission of CS worsens after 10 years, and correlates with baseline scores. Interventions to improve quality of life at early stages may help to prevent further deterioration in the future.