ECE2024 Poster Presentations Late-Breaking (77 abstracts)
The impact of the acromegalic arthropathy on daily functioning in patients with acromegaly
Megan Heague 1 , Sophie Hebden 1 , Julie Lynch 2 , Nawaz Z Safdar 2 , David McLaren 2,3 , Alberto Stefano Tresoldi 4,5,6 , Kirstie Lithgow 4,5,6 , Sandrine Urwyler 4,5,6 , Chetna Varsani 7,8 , Shahzad Akbar 9 , Katie McLoughlin 10 , Katarzyna Adeniji 10 , Tara Kearney 10 , Thozhukat Sathyapalan 9 , Claire Higham 11 , William Drake 7 , Niki Karavitaki 4,5,6 , Nikolaos Kyriakakis 2 & Robert D Murray 2,3
1University of Leeds, School of Medicine, Leeds, United Kingdom; 2Leeds Teaching Hospitals NHS Trust, Department of Endocrinology, Leeds, United Kingdom; 3University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), Leeds, United Kingdom; 4University of Birmingham, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, Birmingham, United Kingdom; 5Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom; 6University Hospitals Birmingham NHS Foundation Trust, Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom; 7Barts Health NHS Trust, Department of Endocrinology, St Bartholomew’s Hospital, London, United Kingdom; 8Barts Health NHS Trust, Department of Endocrinology, St Bartholomew’s Hospital, London, United Kingdom; 9Hull University Teaching Hospitals NHS Trust, Department of Academic Diabetes and Endocrinology, Hull, United Kingdom; 10Salford Royal NHS Foundation Trust, Department of Endocrinology, Salford, United Kingdom; 11The Christie NHS Foundation Trust, Department of Endocrinology, Manchester, United Kingdom
Background: Despite biochemical control of GH and IGF-I levels patients with acromegaly continue to have marked impairment of their well-being. The acromegalic arthropathy has been identified as a significant contributor to the impaired well-being of these individuals. Few data are available to determine the impact of the arthropathy on function.
Methods: Patients with a diagnosis of acromegaly under follow-up in six tertiary pituitary centres were invited to complete a questionnaire relating to joint pain and distribution; and impact on function and QoL. We present data from (1) ‘Disabilities of the Arm, Shoulder and Hand (DASH); (2) Oswestry Disability Index (ODI) to assess the impact of back pain; (3) Knee injury and Osteoarthritis Outcome Score (KOOS); (4) Foot Function Index (FFI); and (5) Health Assessment Questionnaire Disability Index (HAQ-DI). Scores range from 0 (no disability) to 100 (most severe disability) for the DASH, ODI and FFI; in contrast scores for the KOOS subscales are reversed with a score of 100 representing no disability. HAQ-DI values 0 to 1 are considered to represent mild to moderate difficulty, 1 to 2 moderate to severe disability, and 2 to 3 severe to very severe disability.
Results: 411 patients completed the questionnaires, median age 60 (range 18-88) yrs, 56.1% female and mean age at diagnosis 43 (range 12-83) yrs, with duration of disease 13 (IQR 5.9-20.9) years. The median DASH score was 10.8 (IQR 0.8–32.8) and for the ODI 12 (IQR 0–32). Values for the KOOS subscales were KOOS-pain (80.6, IQR 58.3–100.0); KOOS-symptoms 80.0 (IQR 57.1–96.4); KOOS-ADL 87.5 (58.8–100.0); KOOS-sport function 75.0 (IQR 35–100.0); and KOOS-QoL 68.8 (IQR 43.8–100.0). The median FFI was 0.0 (IQR 0–32.4). The median HAQ-DI score was 0.25 (IQR 0.0-1.13), however 43 patients had a HAQ-DI score >2 consistent with severe disability and 75 a score of 1-2 in keeping with moderate to severe disability. 253 had inactive and 155 active disease. No difference in any questionnaire score was observed between patients with active and inactive disease. No correlation between any of the questionnaire scores and duration of acromegaly was observed.
Conclusions: Patients with a history of acromegaly demonstrate functional impairment which is greatest in areas which correlate with the most frequently affected joints (such as the knee joint). Moderate to severe disability is present in approximately 25% of individuals.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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