Quality of Life in Acromegaly: Results From the ACROFAST Study.

INTRODUCTION

Quality of life (QoL) is impaired in acromegaly, particularly in patients with active disease. Improvement of symptoms following hormonal normalization is expected to positively affect QoL.

OBJECTIVE

To assess whether earlier and more effective disease control, achieved in the ACROFAST study, is associated with improvements in AcroQoL scores and symptom burden evaluated by the Patient-Assessed Acromegaly Symptom Questionnaire (PASQ) questionnaire.

METHODS

AcroQoL and PASQ outcomes were analyzed within the ACROFAST study timeframe, comparing controlled and uncontrolled patients. Assessments were performed at baseline, 6 months, and 12 months.

RESULTS

No differences in global AcroQoL scores were observed between treatment arms. However, hormonally controlled patients presented better results in the appearance sub-dimension of the AcroQoL (59 ± 19 vs 45 ± 20 points; P = .04) and in PASQ score (15 ± 12 vs 23 ± 10 points; P = .01) at the end of the study. Paired analyses confirmed improvement in PASQ among controlled patients, and linear mixed-effects modelling further demonstrated a reduction over time (estimated marginal means: 19, 14, 14), while scores remained stable in uncontrolled patients. Sub-group analysis revealed that women had worse scores for both QoL and symptoms tests. Severity of symptoms correlated with QoL.

CONCLUSION

Biochemical control is associated with improved symptoms and appearance-related QoL. A personalized approach, which is more effective achieving biochemical control than the standard one, may provide additional patient centered benefits, even if this study only provides indirect evidence. Women exhibited poorer QoL despite similar control rates, suggesting unmet supportive care needs in this subgroup.