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Publications

Journal Article Ahead of print

PubMed: 41823238 DOI: 10.1093/ejendo/lvag047

Progression of acromegalic joint and psychological complications according to sex, treatments and disease control.

Eur J Endocrinol

Authors: Biagio Cangiano, Matteo Corbetta, Caterina Premoli, Davide Soranna, Giovanni Vitale, Silvia Grottoli, Valeria Cambria, Pietro Maffei, Francesca Dassie, Salvatore Cannavò, Marta Ragonese, Antonella Zambon, Marco Bonomi, Luca Persani, Letizia Maria Fatti, Massimo Scacchi

Affiliations

  • Istituto Auxologico Italiano IRCCS, Department of Endocrine and Metabolic Diseases, Milan, Italy.
  • Dept of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
  • Istituto Auxologico Italiano, IRCCS, Milan, Italy.
  • Dept of Medical Sciences, University of Turin, Turin, Italy.
  • Dept of Medicine-DIMED, University of Padua, Padua, Italy.
  • Dept of Human Pathology, University of Messina, Messina, Italy.
  • Endocrine Unit, University Hospital of Messina, Messina, Italy.
  • Division of Biostatistics, Epidemiology and Public Health, Dept of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
  • Istituto Auxologico Italiano, IRCCS, Division of General Medicine, Ospedale S. Giuseppe, Oggebbio-Piancavallo, Verbania, Italy.
  • Dept of Clinical Sciences and Community Health, Dipartimento di Eccellenza 2023-2027, University of Milan, Milan, Italy.

Abstract

BACKGROUND

Articular and psychological complications of acromegaly are known to impair patients' quality of life (QoL). This multicenter prospective observational study aimed to: (1) identify clinical predictors of the progression of these complications, (2) evaluate their progression in relation to disease activity, and (3) assess their impact on QoL.

MATERIALS AND METHODS

Ninety-five patients with acromegaly were enrolled, excluding those with inflammatory rheumatic diseases. Clinical history, hormonal and physical exams were collected at baseline and after 42 months. Specific questionnaires assessing joint and psychological discomfort (WOMAC, AIMS, VAS) and QoL (AcroQoL) were administered.

RESULTS

A regression model identified clinical predictors of progression. Female sex was significantly associated with worsening joint symptoms (VAS p=0.0302; AIMS symptoms p=0.0328), as was prior radiotherapy (AIMS p=0.0071). Use of dopamine agonists (DAs) was linked to higher AIMS depression scores (p=0.0224). Interestingly, patients with disease recurrence showed lower joint pain scores compared with baseline. In contrast, mood scores improved with disease remission. Notably, suicide emerged as a relevant cause of death in this cohort, underscoring the need for comprehensive psychological care.

CONCLUSIONS

Female sex and prior radiotherapy emerged as predictors of progressive joint symptom worsening. Changes in depression and joint complaints alongside disease course suggest a complex involvement of IGF1. Dopamine agonists may negatively affect mood, though further studies are needed. Overall, joint disease had a greater and independent negative impact on QoL compared to mood disorder. Articular and psychological complications remain a significant burden, particularly in women with acromegaly.

MeSH

Depression, Radiotherapy, Joint Diseases, Hormones, Signs And Symptoms, Endocrine Glands, Acromegaly, Sex, Therapeutics, Dopamine Agonists, Endocrine System Diseases, Suicide