Acromegaly disease activity according to ACRODAT®, a cross-sectional study in Spain: ACROVAL study

• Published in: Endocrine 2022-02, Vol.75 (2), p.525-536
• Main Authors: Marazuela, Mónica, Blanco, Concepción, Bernabeu, Ignacio, Menendez, Edelmiro, Villar, Rocío, Paja, Miguel, Sampedro-Nuñez, Miguel, Samaniego, M. Luz, Díaz-Muñoz, Marcos, Sánchez-Cenizo, Laura
• Format: Article
• Language: English
• Subjects: Acromegaly; Acromegaly - drug therapy; Adult; Cross-Sectional Studies; Diabetes; Drug therapy; Endocrinology; Humanities and Social Sciences; Humans; Insulin-Like Growth Factor I; Internal Medicine; Medicine; Medicine & Public Health; multidisciplinary; Original; Original Article; Patients; Quality of Life; Science; Spain - epidemiology; Surveys and Questionnaires
• ISSN: 1355-008X; 1559-0100
• DOI: 10.1007/s12020-021-02900-0

Objectives To evaluate disease activity status using the Acromegaly Disease Activity Tool (ACRODAT ® ) in a cohort of Spanish acromegaly patients, to assess the relationship between the level of disease activity according to both ACRODAT ® and the physicians’ clinical evaluation, and to study the potential discrepancies in the perception of symptoms between physicians and patients. Design Multicenter, observational, descriptive and cross-sectional study. Methods Disease activity was assessed in adult patients with acromegaly under pharmacological treatment during at least 6 months using ACRODAT ® . Results According to ACRODAT ® , 48.2%, 31.8% and 20.0% of a total of 111 patients were classified as having a stable disease (S), mild disease activity (M-DA) and significant disease activity (S-DA) respectively. ACRODAT ® classification of disease activity significantly correlated with physicians’ opinion, with a moderate inter-rater agreement and a specificity of 92.45% (PPV = 86.21%). No correlation was found between IGF-I levels and severity of symptoms or quality of life (QoL). A decision to take clinical action was significantly more frequent in S-DA and M-DA patients than S patients but no action was taken on 5 (22.7%) and 27 (77.1%) S-DA and M-DA patients, respectively Conclusions ACRODAT ® detected disease activity in 51.8% of patients. Interestingly, although M-DA and S-DA patients were likely to be in the process of being controlled, action was not always taken on these patients. ACRODAT ® is a validated and highly specific tool that may be useful to routinely monitor acromegaly and to identify patients with non-obvious disease activity by incorporating “patient-centred” parameters like symptoms and QoL to the clinical evaluation of acromegaly.