Musculoskeletal disease in acromegaly-a population-based registry study

Area of Science:

• Endocrinology
• Rheumatology
• Orthopedics

Background:

• Acromegaly, a disorder caused by excess growth hormone, is linked to significant musculoskeletal issues impacting patient quality of life and work capacity.
• Understanding these complications is crucial for comprehensive patient management.

Purpose of the Study:

• To investigate the risks of osteoarthritis, osteoporosis, fractures, and analgesic use in Danish individuals with acromegaly.
• To assess the incidence of musculoskeletal surgeries, including joint replacements, in this patient cohort.

Main Methods:

• A national, registry-based cohort study was conducted from 1977 to 2021.
• 844 acromegaly patients were matched with 1:100 healthy controls.
• Cox regression and Kaplan-Meier analyses were used to evaluate outcomes.

Main Results:

• Acromegaly patients showed significantly elevated risks for shoulder, hip, and knee osteoarthritis, as well as medically treated osteoporosis, even preceding acromegaly diagnosis.
• The risk of shoulder, hip, and knee replacement surgery was notably higher in acromegaly patients.
• Increased likelihood of requiring weak analgesics or opioids, alongside a higher risk of surgical complications and repeat hip surgery, was observed.

Conclusions:

• Severe, progressive osteoarthritis and medically treated osteoporosis are significant concerns in acromegaly, manifesting even before diagnosis and persisting post-treatment.
• Acromegaly patients have an increased risk of various musculoskeletal surgeries, particularly joint replacements, and require more analgesic medication.
• Further research is recommended to optimize the management of musculoskeletal complications in acromegaly patients.