Quality of life in patients with acromegaly based on the AcroQoL questionnaire

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Abstract

Rationale: International experts emphasize that treatment strategies for patients with acromegaly should be aimed not only at normalization of biochemical parameters, but also at the achievement of better health-related quality of life (HRQL). However, the published data on the quality of life in patients with acromegaly is scarce.

Aim: To assess HRQL in patients with acromegaly with a disease-specific validated questionnaire (AcroQoL) and to identify potential factors that may influence it.

Materials and methods: One hundred fourteen (114) patients aged from 18 to 83 years (median age, 56 years, interquartile range, 46 to 63). All patients were divided into the age groups, as well as into the groups depending on the treatment they had received and on the control of acromegaly.

Results: In the whole group of the patients (n = 114), the levels of insulin-like growth factor I significantly (p = 0.026) correlated with the domain “personal relationships”. When the patients with newly diagnosed acromegaly (n = 34) were compared to those who had been previously treated (n = 80), there were significant differences for “HRQL global” (p = 0.015) and “physical dimension” (p = 0.009). HRQL of the patients with controlled (n = 37) acromegaly did not differ from HRQL of those with uncontrolled disease (n = 43) (p > 0.05). Surgery and radiation treatment had no impact on the patients' HRQL (p > 0.05), whereas the treatment with somatostatin analogues improved only its physical dimension (p = 0.034).

Conclusion: Treatment interventions do not improve quality of life in patients with acromegaly. This can be explained as follows: modern treatment approaches (surgery, radiation) do not lead to immediate noticeable results, whereas treatment-related complications can manifest themselves clearly. As a result, the patient may get an impression that his/ hers quality of life has not improved, despite the fact that the expediency of the specific treatment administered has been absolutely proven.

About the authors

A. V. Dreval

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Alexandr V. Dreval – MD, PhD, Professor, Head of Department of Therapeutic Endocrinology.

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

Yu. G. Pokramovich

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: pokramovich_81@mail.ru

Yulia G. Pokramovich – MD, Research Fellow, Department of Therapeutic Endocrinology.

61/2-9 Shchepkina ul., Moscow, 129110, Tel.: +7 (495) 688 74 92

Russian Federation

I. A. Ilovayskaya

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Irena A. Ilovayskaya – MD, PhD, Senior Research Fellow, Department of Therapeutic Endocrinology; Assosiate Professor, Chair of Endocrinology, Postgraduate Training Faculty.

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

A. D. Gilyazova

Policlinic No 3 of Medical and Sanitary Part of the Ministry of Internal Affairs (Moscow)

Email: fake@neicon.ru

Aliya D. Gilyazova – MD, Physician Endocrinologist.

8 Bochkova ul., Moscow, 129085

Russian Federation

References

  1. Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, Strasburger CJ, Wass JA, Giustina A. A consensus on the diagnosis and treatment of acromegaly complications. Pituitary. 2013;16(3): 294–302. doi: 10.1007/s11102-012-0420-x.
  2. Афанасьева ЕВ. Оценка качества жизни, связанного со здоровьем. Качественная клиническая практика. 2010;(1): 36–8.
  3. Webb SM, Prieto L, Badia X, Albareda M, Catalá M, Gaztambide S, Lucas T, Páramo C, Picó A, Lucas A, Halperin I, Obiols G, Astorga R. Acromegaly Quality of Life Questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol (Oxf). 2002;57(2): 251–8. doi: 10.1046/j.1365-2265.2002.01597.x.
  4. Webb SM, Badia X, Surinach NL; Spanish AcroQol Study Group. Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol. 2006;155(2): 269–77. doi: 10.1530/eje.1.02214.
  5. Geraedts VJ, Andela CD, Stalla GK, Pereira AM, van Furth WR, Sievers C, Biermasz NR. Predictors of quality of life in acromegaly: no consensus on biochemical parameters. Front Endocrinol (Lausanne). 2017;8:40. doi: 10.3389/fendo.2017.00040.
  6. Crespo I, Valassi E, Webb SM. Update on quality of life in patients with acromegaly. Pituitary. 2017;20(1): 185–8. doi: 10.1007/s11102-0160761-y.
  7. Rowles SV, Prieto L, Badia X, Shalet SM, Webb SM, Trainer PJ. Quality of life (QOL) in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire. J Clin Endocrinol Metab. 2005;90(6): 3337–41. doi: 10.1210/jc.2004-1565.
  8. Paisley AN, Rowles SV, Roberts ME, Webb SM, Badia X, Prieto L, Shalet SM, Trainer PJ. Treatment of acromegaly improves quality of life, measured by AcroQol. Clin Endocrinol (Oxf). 2007;67(3): 358–62. doi: 10.1111/j.13652265.2007.02891.x.
  9. Mangupli R, Camperos P, Webb SM. Biochemical and quality of life responses to octreotide-LAR in acromegaly. Pituitary. 2014;17(6): 495–9. doi: 10.1007/s11102-0130533-x.
  10. Fathalla H, Cusimano MD, Alsharif OM, Jing R. Endoscopic transphenoidal surgery for acromegaly improves quality of life. Can J Neurol Sci. 2014;41(6): 735–41. doi: 10.1017/cjn.2014.106.
  11. Matta MP, Couture E, Cazals L, Vezzosi D, Bennet A, Caron P. Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance. Eur J Endocrinol. 2008;158(3): 305– 10. doi: 10.1530/EJE-07-0697.
  12. Postma MR, Netea-Maier RT, van den Berg G, Homan J, Sluiter WJ, Wagenmakers MA, van den Bergh AC, Wolffenbuttel BH, Hermus AR, van Beek AP. Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly. Eur J Endocrinol. 2012;166(4): 585–92. doi: 10.1530/EJE-11-0853.
  13. Kyriakakis N, Lynch J, Gilbey SG, Webb SM, Murray RD. Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: Results from a 5-years prospective study. Clin Endocrinol (Oxf). 2017;86(6): 806–15. doi: 10.1111/cen.13331.
  14. Andela CD, Biermasz NR, Kaptein AA, Pereira AM, Tiemensma J. More concerns and stronger beliefs about the necessity of medication in patients with acromegaly are associated with negative illness perceptions and impairment in quality of life. Growth Horm IGF Res. 2015;25(5): 219–26. doi: 10.1016/j.ghir.2015.06.008.
  15. T'Sjoen G, Bex M, Maiter D, Velkeniers B, Abs R. Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian registry on acromegaly. Eur J Endocrinol. 2007;157(4): 411–7. doi: 10.1530/EJE-07-0356.
  16. Chin SO, Chung CH, Chung YS, Kim BJ, Kim HY, Kim IJ, Kim JG, Kim MS, Kim SY, Lee EJ, Lee KY, Kim SW. Change in quality of life in patients with acromegaly after treatment with octreotide LAR: first application of AcroQoL in Korea. BMJ Open. 2015;5(6):e006898. doi: 10.1136/bmjopen-2014-006898.
  17. Geraedts VJ, Dimopoulou C, Auer M, Schopohl J, Stalla GK, Sievers C. Health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life. Front Endocrinol (Lausanne). 2015;5:229. doi: 10.3389/fendo.2014.00229.
  18. Miller A, Doll H, David J, Wass J. Impact of musculoskeletal disease on quality of life in long-standing acromegaly. Eur J Endocrinol. 2008;158(5): 587–93. doi: 10.1530/EJE-07-0838.
  19. Celik O, Hatipoglu E, Akhan SE, Uludag S, Kadioglu P. Acromegaly is associated with higher frequency of female sexual dysfunction: experience of a single center. Endocr J. 2013;60(6): 753–61. doi: 10.1507/endocrj.EJ12-0424.
  20. Webb SM, Badia X. Quality of Life in Acromegaly. Neuroendocrinology. 2016;103(1): 106–11. doi: 10.1159/000375451.
  21. Древаль АВ, Покрамович ЮГ, Тишенина РС. Эффективность аналога соматостатина длительного действия Октреотида-депо в лечении больных с активной фазой акромегалии. Проблемы эндокринологии. 2014;60(3): 10–4. doi: 10.14341/probl201460310-14.
  22. Древаль АВ, Покрамович ЮГ, Триголосова ИВ, Виноградова АВ, Иловайская ИА. Эффективность лечения различными дозами Сандостатина ЛАР пациентов с акромегалией в Московской области. Альманах клинической медицины. 2014;(32): 31–5. doi: 10.18786/2072-0505-2014-32-31-35.

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Copyright (c) 2018 Dreval A.V., Pokramovich Y.G., Ilovayskaya I.A., Gilyazova A.D.

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