Treatment of acromegaly improves quality of life, measured by AcroQol.
BACKGROUND
AcroQol is a disease-generated questionnaire, developed to assess quality of life (QOL) in patients with acromegaly. We have previously demonstrated severely impaired QOL in patients with acromegaly and the value of AcroQol in measuring QOL in a cross-sectional study compared with the non-disease-specific generic tools 'Psychological general wellbeing schedule' (PGWBS) and EuroQol (EQ-5D), and the disease-specific signs and symptoms score (SSS). AIM, SUBJECTS AND METHODS: We re-evaluated these tools in a longitudinal study of 56 of the previously reported patients (33 male, mean age 55 +/- 15 years), in order to determine change in QOL over time and the effect of different treatment modalities. Data were analysed using Spearman's correlation tests.


RESULTS
Baseline median IGF-I was 354 ng/ml (range 48-899) and at re-evaluation 217 ng/ml (60-594) (P < 0.001) [median time interval 608 days (113-1136)]. Analysis of change in IGF-I levels and AcroQol scores demonstrated a significant negative correlation (i.e. a reduction in IGF-I being associated with improved overall QOL (r = -0.36, P = 0.006). Significant negative correlations were also seen in the physical (r = -0.33, P = 0.01), psychological (r = -0.37, P = 0.005) and appearance (r = -0.42, P = 0.001) AcroQol subdomains. No correlations were seen between change in IGF-I and change in overall PGWBS score or subdomains, SSS or EQ-5D.


CONCLUSIONS
In summary, of the tools studied we have demonstrated AcroQol to be uniquely capable of detecting changes in QOL associated with treatment-induced improvement in the main biochemical marker of disease activity in patients with acromegaly. Further studies are required to evaluate the long-term biological significance of the changes seen in AcroQol.
Paisley
Angela N
AN
Department of Endocrinology, Christie Hospital, Wilmslow Road, Manchester, UK.
Rowles
Susannah V
SV
Roberts
Margaret E
ME
Webb
Susan M
SM
Badia
X
X
Prieto
L
L
Shalet
Stephen M
SM
Trainer
Peter J
PJ
D000172:Acromegaly / Q000188:drug therapy* / Q000523:psychology* / Q000601:surgery; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D006304:Health Status; D006728:Hormones / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011878:Radiotherapy; D013004:Somatostatin / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D018491:Dopamine Agonists; D006728:Hormones; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; C406545:pegvisomant