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Introduction: ACRODAT® (Acromegaly Disease Activity Tool) is a new disease-specific tool intended to assist endocrinologists in evaluating disease activity in patients with acromegaly. ACRODAT® uses five disease-specific parameters (IGF-1, tumor status, comorbidities, symptoms and quality of life) to classify disease activity as stable (S), mild (M-DA), or significant (S-DA). Due to the recent development of the tool, its clinical application has not been studied yet. Aim: This study was aimed to evaluate disease activity status using ACRODAT® in a cohort of Spanish patients with acromegaly. Other secondary objectives were to assess the relationship between patient demographic characteristics and ACRODAT® disease categories; to analyze the correlation between classification of disease activity by ACRODAT® and by physician criteria and to study the potential discrepancies between symptoms perception between physicians and patients. Methodology: Multicenter, observational, descriptive, cross-sectional study in adult patients with acromegaly under pharmacological treatment during at least 6 months. Quality of life (QoL) was determined by the AcroQoL questionnaire. Severity of symptoms was quantified using PASQ questionnaire, fulfilled by patients (paPASQ) and by physicians (phPASQ). ACRODAT® tool was used to assess disease activity entering the data collected in the study. Results: 111 patients were included in the analysis with a mean age of 59.7 years (51.4% women). According to ACRODAT®, 48.2%, 31.8% and 20.0% of patients were classified as S, M-DA and S-DA respectively. Patients with S-DA were younger, had higher IGF-1 levels, worst QoL and less stable treatment than S patients. M-DA patients had higher IGF-1 levels (but lower than S-DA patients), more severe symptoms and worst QoL than S-patients. 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%). phPASQ significantly correlated with paPASQ with a substantial inter-rater agreement. No correlation was found between IGF-1 levels and PASQ or AcroQoL. Decision taken by physician was significantly more frequent in S-DA patients than S patients, but no action was taken in 5 (22.7%) S-DA patients. Conclusions: ACROVAL® detected disease activity in 51.8% of patients. Interestingly, although S-DA patients were likely to be in the process of being controlled, action was not always taken in these patients. This study demonstrated that ACRODAT® is a validated and highly specific tool that may be useful to identify patients with non-obvious disease activity by incorporating “patient-centered” parameters like PASQ and AcroQoL. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO. |
