Soluble klotho: A possible predictor of quality of life in acromegaly patients

Eva Coopmans; Nour El-Sayed; Jan Frystyk; Magnusson Nils Erik; Jorgensen Jens Otto; Van der Lely Aart Jan; Joseph AM Janssen; Ammar Muhammad; Sebastian Neggers

doi:10.1530/endoabs.70.AEP748

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Endocrine Abstracts (2020) 70 AEP748 | DOI: 10.1530/endoabs.70.AEP748

ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)

Soluble klotho: A possible predictor of quality of life in acromegaly patients

Eva Coopmans ¹ , Nour El-Sayed ¹ , Jan Frystyk ^2,3,4 , Nils Erik Magnusson ⁴ , Jens Otto Jorgensen ⁵ , Aart Jan Van der Lely ¹ , Joseph AM Janssen ¹ , Ammar Muhammad ¹ & Sebastian Neggers ¹

Err

Author affiliations

¹Erasmus MC, Rotterdam, Netherlands; ²Odense University Hospital, Odense, Denmark; ³University of Southern Denmark, Sønderborg, Denmark; ⁴Aarhus University, Aarhus, Denmark; ⁵Aarhus University Hospital, Aarhus, Denmark

Purpose: Although quality of life (QoL) is improved in patients with acromegaly after disease control, QoL correlates only weakly with traditional biomarkers. Our objective is to investigate a potential relation between the new serum biomarker soluble Klotho (sKlotho), GH and insulin-like growth factor 1 (IGF-1) levels and QoL.

Methods: In this prospective cohort study, we investigated 54 acromegaly patients biochemically well-controlled on combination treatment with first-generation somatostatin receptor ligands (SRLs) and pegvisomant (PEGV) at baseline and nine months after switching to pasireotide LAR (PAS-LAR; either as monotherapy, n = 28; or in combination with PEGV, n = 26). QoL was measured by the Patient-Assessed Acromegaly Symptom Questionnaire (PASQ) and Acromegaly Quality of Life (AcroQoL) questionnaire.

Results: Switching to PAS-LAR treatment significantly improved QoL without altering IGF-1 levels. QoL did not correlate with GH or IGF-1 levels, but sKlotho correlated with the observed improvements in QoL by the AcroQoL global (r = −0.35, P = 0.012) and physical sub-dimension (r = −0.34, P = 0.017), and with PASQ headache (r = 0.28, P = 0.048), osteoarthralgia (r = 0.46, P = 0.00080) and soft tissue swelling score (r = 0.29, P = 0.041). Parallel changes in serum sKlotho and IGF-1 (r = 0.31, P = 0.023) suggest sKlotho and IGF-1 to be similarly dependent on GH. Comparing the PAS-LAR combination therapy and the monotherapy group we did not observe a significant difference in improvement of QoL.

Conclusion: Patients experienced improved QoL during PAS-LAR, either as monotherapy or in combination with PEGV. Soluble Klotho concentrations appear to be a useful marker of QoL in acromegaly patients but the underlying mechanisms remain to be investigated.