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Health-related quality of life in patients with non-functioning pituitary adenoma: a special focus on hydrocortisone replacement dose

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Abstract

Purpose

Patients with non-functioning pituitary adenomas (NFPA) suffer from pronounced impairments in physical and mental measures that result in an impairment of health-related quality of life (HRQOL). The role of secondary adrenal insufficiency (SAI) and especially the one of the hydrocortisone (HC) replacement dose on the HRQOL seems to be conflicting. The primary aim of this study is to assess the HRQOL in patients with NFPA in terms of presence of SAI and in patients without SAI and the secondary to explore the impact of treatment parameters such as daily HC dose.

Design/Methods

In a cross-sectional study we evaluated parameters of HRQOL in 95 patients with NFPA of the Endocrine Outpatient Unit of the Max Planck Institute of Psychiatry in Munich using standardized questionnaires like Short Form (SF-36), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and a self-constructed questionnaire about medical history.

Results

We could not find any significant difference between patients with and without SAI in the standardized questionnaires in terms of HRQOL. We could show that higher doses of HC were negatively correlated with HRQOL measured by SF-36 global health score regardless of using BDI or STAI in the block (β =  − 0.397; p = 0.021, β =  − 0.390; p = 0.016, respectively).

Conclusions

NFPA patients with SAI do not have a worse HRQOL than patients with NFPA and intact corticotropic axis. We could show that higher doses of HC are associated with an impaired HRQOL measured by SF-36 global and physical health score, whereas mental health score is not significantly influenced by the HC dose.

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Funding

This study received no funding.

Author information

Author notes

  1. Matthias K. Auer and Anastasia P. Athanasoulia-Kaspar have shared last authorship.

Authors and Affiliations

  1. Gynecology and Obstetrics, Medical Faculty, University of Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany

    Carl Mathis Wild

  2. Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians Universität München, Ziemssenstr. 1, 80336, Munich, Germany

    Mareike Stieg, Günter K. Stalla & Matthias K. Auer

  3. Medicover Neuroendocrinology, Orleansplatz 3, 81667, Munich, Germany

    Günter K. Stalla & Anastasia P. Athanasoulia-Kaspar

Authors
  1. Carl Mathis Wild
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  2. Mareike Stieg
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  3. Günter K. Stalla
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  4. Matthias K. Auer
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  5. Anastasia P. Athanasoulia-Kaspar
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Corresponding author

Correspondence to Anastasia P. Athanasoulia-Kaspar.

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Conflict of interest

CMW and MKA declare no conflict of interest. MS received speakers’ fees by Novartis, Ipsen, Pfizer, consultancy fees by Novartis and research funding by Novartis, Pfizer. APAK and GKS received consultancy fees and/or reimbursements of delegate fees for conferences/educational events and/or travel expenses and/or funding for research projects from Pfizer, Ipsen, Lilly, Shire, Novartis, Sandoz, NovoNordisk, and HRA.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Research involving human participants and/or animals

The study was an observational, non-interventional study involving human participants.

Informed consent

The study was approved by the medical ethics committee of the Ludwig-Maximilians-University of Munich. Informed consent was obtained from all individual participants included in the study.

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Wild, C.M., Stieg, M., Stalla, G.K. et al. Health-related quality of life in patients with non-functioning pituitary adenoma: a special focus on hydrocortisone replacement dose. Qual Life Res 29, 3325–3331 (2020). https://doi.org/10.1007/s11136-020-02582-7

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  • DOI: https://doi.org/10.1007/s11136-020-02582-7

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