期刊
CLINICAL ENDOCRINOLOGY
卷 94, 期 1, 页码 58-65出版社
WILEY
DOI: 10.1111/cen.14309
关键词
acromegaly; pegvisomant; quality of life; somatostatin analog
资金
- Pfizer
- National Institutes of Health [K24 HL092902, T32 DK007028, K23 DK113220, K23 DK115903]
- Harvard Catalyst|The Harvard Clinical and Translational Science Center (National Center for Research Resources, National Institutes of Health) [UL1 TR001102]
- Harvard Catalyst|The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health) [UL1 TR001102]
- Harvard University
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts
This study investigated the effects of growth hormone receptor antagonism versus somatostatin analog therapy on the quality of life in patients with acromegaly. The results showed that there were no significant differences in quality of life between patients receiving different treatment regimens, but higher HbA1c, BMI, and IGF-1 Z-scores were associated with poorer quality of life in several domains.
Objective Acromegaly is associated with impaired quality of life (QoL). We investigated the effects of biochemical control of acromegaly by growth hormone receptor antagonism vs somatostatin analog therapy on QoL. Design Cross-sectional. Patients 116 subjects: n = 55 receiving a somatostatin analog (SSA group); n = 29 receiving pegvisomant (PEG group); n = 32 active acromegaly on no medical therapy (ACTIVE group). Measurements Acromegaly QoL Questionnaire (AcroQoL), Rand 36-Item Short Form Survey (SF-36) and Gastrointestinal QoL Index (GIQLI); fasting glucose, insulin and IGF-1 levels (LC/MS, Quest Diagnostics). Results There were no group differences in mean age, BMI or sex [(whole cohort mean +/- SD) age 52 +/- 14 years, BMI 30 +/- 6 kg/m(2), and male sex 38%]. Mean IGF-1 Z-scores were higher in ACTIVE (3.9 +/- 1.0) vs SSA and PEG, which did not differ from one another (0.5 +/- 0.7 and 0.5 +/- 0.7,P < .0001 vs ACTIVE). Eighty-three per cent of PEG previously received somatostatin analogs, which had been discontinued due to lack of efficacy (52%) or side effects (41%). There were no differences in the four QoL primary end-points (AcroQoL Global Score, SF-36 Physical Component Summary Score, SF-36 Mental Health Summary Score and GIQLI Global Score) between SSA and PEG. Higher HbA1c, BMI and IGF-1 Z-scores were associated with poorer QoL in several domains. Conclusion Our data support a comparable QoL in patients receiving pegvisomant vs somatostatin analogs, despite the fact that the vast majority receiving pegvisomant did not respond to or were not able to tolerate somatostatin analogs.
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