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Clinical, quality of life, and economic value of acromegaly disease control
A Ben-Shlomo1, M C Sheppard, J M Stephens
1Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 110 George Burns Rd, Los Angeles, CA, 90048, USA.
Insights
Controlling acromegaly by normalizing growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels improves clinical outcomes, quality of life, and reduces treatment costs. Achieving disease control is crucial for managing this rare condition.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Rare Diseases
Background:
- Acromegaly presents a significant clinical, economic, and quality of life burden due to comorbidities and lifelong management needs.
- Disease control is defined by normalized growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels.
- Uncontrolled acromegaly is associated with increased mortality risk.
Purpose of the Study:
- To review the benefits of disease control on clinical, health-related quality of life (HRQoL), and economic outcomes in acromegaly patients.
- To assess the impact of normalized GH and IGF-1 on patient well-being and healthcare resource utilization.
Main Methods:
- Comprehensive literature review spanning 12 years (1998-2010).
- Analysis of studies focusing on disease control parameters (GH <2.5 μg/l, normal IGF-1) and their impact on various outcomes.
Main Results:
- Disease control positively impacts joint cartilage, vertebral fractures, cardiac function, exercise capacity, lipid profiles, and obstructive sleep apnea.
- Improved health-related quality of life (HRQoL) is associated with controlled acromegaly.
- Direct treatment costs are higher in patients with uncontrolled acromegaly, with additional costs from comorbidity management and indirect expenses.
Conclusions:
- Optimizing disease control in acromegaly leads to improved clinical outcomes, enhanced HRQoL, and potentially reduced economic burden.
- Further research is needed to comprehensively evaluate clinical, HRQoL, and economic outcomes associated with controlled acromegaly.
Abstract:
Although acromegaly is a rare disease, the clinical, economic and health-related quality of life (HRQoL) burden is considerable due to the broad spectrum of comorbidities as well as the need for lifelong management. We performed a comprehensive literature review of the past 12 years (1998-2010) to determine the benefit of disease control (defined as a growth hormone [GH] concentration <2.5 μg/l and insulin-like growth factor [IGF]-1 normal for age) on clinical, HRQoL, and economic outcomes. Increased GH and IGF-1 levels and low frequency of somatostatin analogue use directly predicted increased mortality risk. Clinical outcome measures that may improve with disease control include joint articular cartilage thickness, vertebral fractures, left ventricular function, exercise capacity and endurance, lipid profile, and obstructive apnea events. Some evidence suggests an association between controlled disease and improved HRQoL. Total direct treatment costs were higher for patients with uncontrolled compared to controlled disease. Costs incurred for management of comorbidities, and indirect cost could further add to treatment costs. Optimizing disease control in patients with acromegaly appears to improve outcomes. Future studies need to evaluate clinical outcomes, as well as HRQoL and comprehensive economic outcomes achieved with controlled disease.
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