Endocrine Abstracts

Objective: We aimed to evaluate the ability of SAGIT Instrument and AcroQoL questionnaire to discriminate acromegaly control status and to correlate SAGIT scores to AcroQoL results in a cohort of the national referral centre.

Methods: Cross-sectional study included 72 patients followed between 2000 and 2020. We retrospectively determined SAGIT score at the diagnosis. Based on the data from the most recent follow up and additional telephone interviews, we determined the patients’ current SAGIT score and assess quality of life by AcroQoL.

Results: At follow up (median duration of 8 (5-12) years), 55 (76.4%) patients were classified as cured or controlled on pharmacotherapy based on biochemical criteria (median IGF-1 0.97 times ULN), while17 patients (23.6%) had uncontrolled disease (median IGF-1 2.65 times ULN). All 5 SAGIT categories significantly lowered from baseline to follow up, with the global score decreasing from 14 (12-15) to 4 (3-6) (P<0.001). The duration of diagnostic delay significantly correlated with subscores S, A, G and global score at diagnosis. SAGIT at baseline did not discriminate the current disease status, whereas the follow up global score and its G and I components discriminated between the current disease activity status, with the global score 4 (3-5) in cured/controlled group vs 6 (4.5-8) in uncontrolled group (P=0.007). At follow up, the median global AcroQoL score for our cohort was 69.3% (50-84.1), with the highest median score in the Personal relationship subscale and the most affected Physical Performance subscale. AcroQoL was not able to discriminate disease activity status. From the examined variables (BMI, IGF-1 levels, time to remission, disease duration, diagnostic delay, age, gender, adenoma size, and the presence of diabetes mellitus and hypopituitarism), only BMI had significant negative correlations with the global AcroQoL score. At baseline and follow up, there were statistically significant negative correlations between SAGIT subscores S and A and all AcroQoL subscales. The presence of swelling at baseline had a significant effect on the global AcroQoL score (P=0.035). At follow up, the significant elements that correlated with the global AcroQol score were joint symptoms (P=0.002), headaches (P<0.001), sleep apnea (P=0.006) and hypertension (P=0.002).

Conclusions: Our results emphasise the complementary nature of Patient- and Clinician-reported outcome tools in assessing acromegaly control status. The data identifies the critical role of signs, symptoms, and associated comorbidities as important patient-oriented treatment targets, beyond SAGIT sub-scores G, I and T, by which clinicians could further increase the impaired QoL in this population.