ECE2024 Poster Presentations Late-Breaking (77 abstracts)
Progression of joint and psychological complications in acromegaly and their association with treatments and disease control
Biagio Cangiano 1,2,3 , Caterina Premoli 2 , Davide Soranna 1 , Giovanni Vitale 1,2 , Silvia Grottoli 4 , Valeria Cambria 4 , Pietro Maffei 5 , Francesca Dassie 5 , Salvatore Cannavò 6 , Marta Ragonese 6 , Antonella Zambon 7 , Luca Persani 1,2 , Letizia Fatti 1 & Massimo Scacchi 3,8
1Istituto Auxologico Italiano IRCCS, Milan, Italy, Division of Endocrine and Metabolic Diseases, Milan, Italy; 2University of Milan, Department of Medical Biotechnology and Translational Medicine, Milan, Italy; 3Istituto Auxologico Italiano IRCCS, Division of General Medicine, Ospedale S. Giuseppe, Verbania, Italy; 4University of Turin, Department of Medical Sciences, Turin, Italy; 5University of Padua, Padua, Italy; 6University Hospital of Messina, Endocrine Unit, Messina, Italy; 7University of Milano-Bicocca, Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, Milan, Italy; 8University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy
Background: Articular and psychological complications of acromegaly are known to impair patients’ quality of life (QoL). The aims of this study are: (1) to look for clinical predictors for the progression of the articular and psychological complications, (2) to evaluate the progression of these complications in relation to the activity of the acromegalic disease, and (3) to evaluate how these complications interact to impair the QoL.
Material and Methods: 97 patients with acromegaly were enrolled in this multicentric observational prospective study, excluding those harboring inflammatory rheumatic diseases. At the beginning of the study and after 42 months, patients’ history, hormonal and physical exams were recorded, and specific questionnaires studying articular and psychological discomfort (WOMAC, AIMS, VAS), as well as a scale for QoL (AcroQoL), were administered to each patient.
Results: The log-gamma model to look for clinical predictors of psychological or articular disease progression, showed a significant correlation of female gender and a worsening of joint symptoms, as measured by VAS (P=0,0139), WOMAC pain (P=0,0415) e AIMS symptoms (P=0,0448) scales; similarly, previous radiation therapy was associated with a significant worsening of symptoms to AIMS questionnaire (P=0,0084). When evaluating the progression of both complications in relation to chronic acromegaly treatments, patients treated with dopamine agonists (DA) showed worsening of the AIMS depression scale over time (P=0.01). By studying the progression of scores in relation to disease activity, we found a paradoxical effect with worsening of arthropathy symptoms in patients gaining hormonal control and improvement in patients with disease recurrence. Depression scores improved, as expected, upon the achievement of disease remission. Finally, arthropathy and depression were confirmed to be independent factors impairing QoL in acromegaly. However, arthropathy showed a greater impact than depression on the worsening of patients’ well-being (P=0,0084 vs P=0,0500).
Conclusion: Female sex was shown not only to be a factor associated with worse joint scores, but also a predictor of worsening joint symptoms over time, along with prior radiotherapy. If depression score decreases as expected once remission is achieved, the paradoxical worsening of arthropathy scores suggests a mixed effect of IGF1 on joint symptoms. DA seem to be associated with worsening of depression score over time, even if this effect must be confirmed in controlled trials. Arthropathy shows a greater but independent effect than depression on QoL.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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