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Increased clinical symptoms of acromegalic arthropathy in patients with long-term disease control: a prospective follow-up study

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Abstract

Arthropathy is an invalidating complication of acromegaly. This arthropathy deteriorates radiographically despite long-term disease control. However, the clinical course and its relationship to the radiographic course are currently unknown. We aimed to investigate the clinical course of arthropathy during follow-up and its relationship to radiographic progression in long-term controlled acromegaly patients. Prospective follow-up study. We studied 58 patients (mean age 62 years, women 41 %) with controlled acromegaly for a mean of 17.6 years. Clinical progression of joint disease was defined at baseline and after 2.6 years, by the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Australian/Canadian Osteoarthritis Index (AUSCAN) questionnaires for lower limb and hand OA, respectively, and performance tests. Potential risk factors for progression were assessed. The clinical course of arthropathy was related to the radiographic course. On average, hand and lower limb function deteriorated during follow-up, despite large interindividual variations. Joint pain was stable over time. High levels of pain and functional impairment at baseline were related to clinical progression of hand pain and functional limitations. High baseline BMI was a risk factor for functional deterioration in the lower limb. The changes in symptoms and radiographic progression during follow-up were not related. In treated acromegaly patients, joint function deteriorates during prolonged follow-up, despite biochemical disease control, although there was interindividual variation. Clinical and radiographic course of arthropathy were not related. Therefore, in clinical practice, a combination of clinical and radiographic assessment is necessary to evaluate the course of acromegalic arthropathy.

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Acknowledgments

This research did not receive any specific Grant from any funding agency in the public, commercial or not-for-profit sector.

Conflict of interest

There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolic Diseases C4-R and Center for Endocrine Tumors Leiden, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands

    K. M. J. A. Claessen, S. R. Ramautar, A. M. Pereira, J. A. Romijn & N. R. Biermasz

  2. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    H. M. Kroon

  3. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands

    M. Kloppenburg

  4. Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

    J. A. Romijn

Authors
  1. K. M. J. A. Claessen
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  2. S. R. Ramautar
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  3. A. M. Pereira
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  4. J. A. Romijn
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  5. H. M. Kroon
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  6. M. Kloppenburg
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  7. N. R. Biermasz
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Correspondence to K. M. J. A. Claessen.

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Claessen, K.M.J.A., Ramautar, S.R., Pereira, A.M. et al. Increased clinical symptoms of acromegalic arthropathy in patients with long-term disease control: a prospective follow-up study. Pituitary 17, 44–52 (2014). https://doi.org/10.1007/s11102-013-0464-6

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  • DOI: https://doi.org/10.1007/s11102-013-0464-6

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