Progression of acromegalic arthropathy in long-term controlled acromegaly patients: 9 years of longitudinal follow-up.
CONTEXT
Joint complaints in patients with acromegaly are common, although the long-term disease course is largely unknown.


OBJECTIVE
This study aims to evaluate the long-term course of acromegalic arthropathy.


DESIGN AND SETTING
A prospective longitudinal cohort study was conducted in controlled acromegaly patients followed at a tertial referral center, with 3 study visits: at baseline and after a median of 2.6 and 9.1 years.


PATIENTS
We included 31 patients with biochemically controlled acromegaly for 2 or more years (49% female; median age, 60 years) at baseline.


MAIN OUTCOME MEASURES
Radiographic arthropathy of the knee, hip, hand, and cervical and lumbar spine were evaluated using Kellgren and Lawrence (KL) scores, developed for assessment of primary osteoarthritis (OA). Radiographic progression was defined as a KL increase above the smallest detectable change. Joint symptoms were assessed using self-reported questionnaires. Progression was defined using existing clinically important cutoff values. Risk factors for progression were investigated using a multivariable model.


RESULTS
All patients had definite radiographic OA at 1 or more joints at baseline. Radiographic progression was observed in 29%, 48%, 84%, and 94% of patients in the knees, hips, hands, and axial joints, respectively. Deterioration in hand-related pain and function was observed in 10 (32.3%) and 11 patients (35.5%), respectively. Solely baseline KL scores of the hip were associated with hip OA progression (OR 1.88; 95% CI, 1.09-3.16).


CONCLUSIONS
Acromegalic arthropathy showed significant radiographic progression over 9.1 years of follow-up in patients in remission, whereas clinical progression was observed less frequently. Future studies should focus on adequate prevention and treatment strategies of acromegalic arthropathy.
['Pelsma|Iris C M|ICM|', 'Biermasz|Nienke R|NR|', 'van Furth|Wouter R|WR|', 'Pereira|Alberto M|AM|', 'Kroon|Herman M|HM|', 'Kloppenburg|Margreet|M|', 'Claessen|Kim M J A|KMJA|']
D000172:Acromegaly D000368:Aged D015415:Biomarkers D015331:Cohort Studies D018450:Disease Progression D005260:Female D005500:Follow-Up Studies D006801:Humans D007592:Joint Diseases D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D009426:Netherlands D011859:Radiography D012074:Remission Induction
arthropathy acromegaly osteoarthritis growth hormone insulin-like growth factor-1 longitudinal follow-up study