SFEBES2022 Poster Presentations Adrenal and Cardiovascular (66 abstracts)
Adrenalectomy for unilateral primary aldosteronism improves quality of life: prospective analyses in the MATCH trial
Brittany Blackstone 1,2 , Emily Goodchild 2,3,4 , Oliver Tooze 5 , Jackie Salsbury 2,4 , Xilin Wu 2,3,4 , Amy Ronaldson 2 , Russell Senanayake 6,4 , Waiel Bashari 6,7 , Giulia Argentesi 2,3,4 , Samuel M. O’Toole 2,3,4,8 , Laila Parvanta 4 , Anju Sahdev 9 , Kate Laycock 2,3,4 , Kennedy Cruickshank 10,11 , Mark Gurnell 6,7 , William M. Drake 3,4 & Morris J. Brown 2,3,4
1Barts Health NHS Trust, London, United Kingdom; 2William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; 3NIHR Barts Cardiovascular Biomedical Research Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; 4Department of Endocrinology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom, London, United Kingdom; 5Cornwall Partnership NHS Foundation Trust, London, United Kingdom; 6Metabolic Research Laboratories, Welcome Trust-MRC Institute of Metabolic Science, and NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; 7Department of Diabetes and Endocrinology, Addenbrooke’s Hospital, Cambridge, United Kingdom; 8Department of Endocrinology, The Royal Hallamshire Hospital, Sheffield, United Kingdom; 9Department of Radiology, St Bartholomew’s Hospital, London, United Kingdom; 10Department of Clinical Pharmacology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom; 11School of Life-Course/ Nutritional Sciences, King’s College London, London, United Kingdom
Background: After adrenalectomy (ADX) for primary aldosteronism (PA), approximately 30% of patients achieve clinical success (normalisation of home BP); many additional patients report feeling subjectively better. We used the non-randomised MATCH study1 to further assess quality of life (QoL) changes in participants.
Objective: Assess QoL using the 36-item Short Form Health Survey (SF-36) after surgical treatment of unilateral PA and medical treatment of (mainly) bilateral PA (MRA group).
Method: Prospective analysis of SF-36 in MATCH, measured at baseline and 6 months after treatment. Summary scores (physical component summary (PCS) and mental component summary (MCS)) of 8 subscales were calculated for completed questionnaires. PCS and MCS range from 0-100, with population mean of 50.
Results: At baseline, all SF-36 subscales were lower in patients with PA (n=71), with PCS 20% lower (SE 1.3), and MCS 13% lower (SE 1.3) vs the general population. At 6 months, ADX (n=44) conferred notable benefit, with PCS improved by 8.9 points (P<0.0001) MCS by 6.29 (P<0.0001), compared to MRA (n=23), where there was decrease in PCS -4.41 (P<0.0001) and MCS -4.8 (P<0.0001). The greatest subscale improvements with ADX were in “emotional wellbeing” and “physical health limitations”. Post-treatment difference in QoL between groups was 10.14 in PCS (SE 1.4) (P<0.0001) and 7.56 in MCS (SE 1.3) (P<0.0001) in favour of ADX.
Conclusion: Patients with PA have a lower QoL than the population average. ADX markedly improves QoL in patients with unilateral PA. Lack of improvement in the patients treated with MRA may reflect difference in pathogenesis, in treatment, or sub-optimal titration of MRA within a surgical study.
Reference: 1. X. Wu, R. Senanayake, E. Goodchild et al. 11C-metomidate PET CT vs Adrenal Vein Sampling for diagnosing surgically curable primary aldosteronism: prospective test validation, and impact of somatic genotype and ethnicity on outcomes, 29 December 2021, PREPRINT Research Square [https://doi.org/10.21203/rs.3.rs-1179128/v1z
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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