scholarly journals Effects of Long-term Growth Hormone Replacement in Adults With Growth Hormone Deficiency Following Cure of Acromegaly: A KIMS Analysis

2014 ◽  
Vol 99 (6) ◽  
pp. 2018-2029 ◽  
Author(s):  
Nicholas A. Tritos ◽  
Gudmundur Johannsson ◽  
Márta Korbonits ◽  
Karen K. Miller ◽  
Ulla Feldt-Rasmussen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
General Population ◽  
Outcome Measures ◽  
Cardiovascular Mortality ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
World Health ◽  
Gh Replacement

Context: GH deficiency (GHD) may occur in adults with cured acromegaly (acroGHD). Objective: Our objective was to examine the effectiveness and safety of GH replacement in acroGHD. Design: This study was a retrospective analysis of data from KIMS (Pfizer International Metabolic Database). Setting: Data were extracted from a pharmaco-epidemiological survey of >16 000 GHD adults from 31 countries. Patients: The effectiveness population included 115 adults with acroGHD and 142 age-, gender-, and body mass index-matched GHD adults with nonfunctioning pituitary adenoma (NFPA) followed up to 5 years on GH. The safety population included 164 adults with acroGHD and 2469 with NFPA, all GH-replaced. Both acroGHD and NFPA were compared with several cohorts from the general population (including the World Health Organization Global Burden of Disease). Outcome Measures: Outcome measures included quality of life (QoL-AGHDA), lipids, serious adverse events, and additional safety endpoints. Results: Median GH dose was 0.3 mg/d in acroGHD and NFPA at 5 years. There were comparable improvements in QoL-AGHDA and total and low-density lipoprotein cholesterol in acroGHD and NFPA. High-density lipoprotein cholesterol increased only in acroGHD. Cardiovascular mortality was increased in acroGHD vs NFPA (standardized mortality ratio = 3.03, P = .02). All-cause mortality was similar in acroGHD (ratio between observed/expected cases [95% confidence interval] = 1.32 [0.70–2.25]) and lower in NFPA [observed/expected = 0.58 [0.48–0.70]) in comparison with the general population. There was no difference in incidence of all cancers, benign or malignant brain tumors, or diabetes mellitus between acroGHD and NFPA. Conclusions: GH replacement has comparable effects on quality of life and lipids in acroGHD and NFPA. Further investigation is needed to examine whether the increased cardiovascular mortality may be attributed to the history of previous GH excess in acroGHD.

scholarly journals Healthcare utilization, quality of life and patient-reported outcomes during two years of GH replacement therapy in GH-deficient adults – comparison between Sweden, The Netherlands and Germany

2006 ◽  
Vol 154 (6) ◽  
pp. 843-850 ◽  
Author(s):  
Bernhard Saller ◽  
Anders F Mattsson ◽  
Peter H Kann ◽  
Hans P Koppeschaar ◽  
Johan Svensson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
Replacement Therapy ◽  
Healthcare Utilization ◽  
Patient Reported Outcomes ◽  
Gh Deficiency ◽  
European Countries ◽  
Gh Replacement ◽  
Patient Reported

Objective: This study set out to determine the change in quality of life (QoL) and healthcare utilization during 2 years of growth hormone (GH) replacement therapy in adults with GH deficiency. Data were compared from three European countries. Design: Analysis was made from KIMS, the Pfizer International Metabolic Database on adult GH deficiency. Methods: QoL and healthcare utilization were measured at baseline and after 1 and 2 years of GH replacement in patient cohorts from Sweden (n = 302), The Netherlands (n = 103) and Germany (n = 98). QoL was assessed by the QoL-Assessment in Growth Hormone Deficient Adults (QoL-AGHDA) questionnaire, and the KIMS Patient Life Situation Form was used to evaluate healthcare utilization. Results: QoL improved significantly (P < 0.0001) and comparably in all three cohorts. The improvement was seen during the first year of treatment and QoL remained improved during the second year. The number of days in hospital was reduced by 83% (P < 0.0001) during GH replacement. There were no country-specific differences either at baseline or during follow-up. The same was true for the number of days of sick leave (reduction of 63%; P = 0.0004). Significant reductions were recorded in the number of doctor visits in each of the three cohorts after 2 years of GH replacement (P < 0.05). Conclusions: This study provides a detailed comparative analysis of GH replacement therapy in GHD patients in three European countries. Despite some differences in treatment strategies, the beneficial effects on QoL, patient-reported outcomes and healthcare utilization are essentially similar in the healthcare environment of Western European countries.

scholarly journals Acupuncture for Comorbid Mild-Moderate Depression and Chronic Musculoskeletal Pain: Study Protocol for A Randomized Controlled Trial

2021 ◽  
Author(s):  
sheng Li ◽  
Jing Liu ◽  
Jianpeng Huang ◽  
Ding Luo ◽  
Qian Wu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effective Treatment ◽  
Musculoskeletal Pain ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Sham Acupuncture ◽  
Chronic Musculoskeletal Pain ◽  
World Health ◽  
Secondary Outcome

Abstract Background: Depression and Chronic musculoskeletal pain (CMSP) are the leading causes of global years lived with disability diseases. Moreover, they often commonly coexist, which made a great difficult to diagnosis and treatment. A safe and effective treatment was urgently need. Previous studies showed that acupuncture was a cost-effective treatment for simple depression or CMSP. But limited evidence showed that acupuncture was effective for depression comorbid CMSP. Methods: This is a randomized, sham acupuncture-controlled trial with three arms: real acupuncture (RA), sham acupuncture (SA) and healthy control (HC). 48 depression combined CMSP participants and 12 healthy people will be recruited from GDTCM hospital and randomized 2:2:1 to RA, SA, HC group. The patients will receive RA or SA intervention for 8 weeks, and HC will not receive any intervention. Upon completion of the intervention, there is a 4 weeks follow-up. The primary outcome measures will be severity of depression and pain which assessed by Hamilton depression rating scale (HAMD-17) and brief pain inventory (BPI), respectively. The secondary outcome measures will be cognitive function, and quality of life which measured by Montreal cognitive assessment (MoCA), P300 and world health organization quality of life (WHOQOL-BREF). In addition, the correlation between brain derived neurotrophic factor (BDNF) and symptoms will also be determined. Discussion: The aim of this study is to evaluate the clinic efficacy and underlying mechanism of acupuncture on depression comorbid CMSP. This study will provide a convenient and cost-effectively means for future prevention and treatment of combined depression and CMSP.Trial registration: This study pre-registered at 2th Feb 2018, at Chinese Clinical Trail Registry (ChiCTR1800014754). The study is on the recruiting status.

Quality of Life and Psychopathology: Investigations into their Relationship

2006 ◽  
Vol 40 (4) ◽  
pp. 333-340 ◽  
Author(s):  
Erik D. Masthoff ◽  
Fons J. Trompenaars ◽  
Guus L. Van Heck ◽  
Paul P. Hodiamont ◽  
Jolanda De Vries
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
The Body ◽  
Life Assessment ◽  
World Health ◽  
Psychiatric Outpatients ◽  
World Health Organization Quality ◽  
Axis I ◽  
Dsm Iv

Objective: Quality of life (QOL) has become a topic of growing interest in medical and psychiatric practice in general, and in research in particular. Although the body of knowledge about the complex relationship between QOL and psychiatric disorders is growing, understanding this relationship still remains difficult. Therefore, the aim of the present study was to get more and new insights into this relationship. It was hypothesized that QOL would be negatively related to the presence as well as the severity of psychopathology. Method: A random sample of Dutch adult psychiatric outpatients (n=410) completed the World Health Organization Quality of Life assessment instrument, abbreviated version (WHOQOL-Bref). In addition, DSM-IV axis I and II diagnoses were obtained. Comparisons were made between scores of the psychiatric outpatients, diagnostic subgroups within this population, and the scores of a general population. Results: Compared with the general population, psychiatric outpatients scored significantly worse on all aspects of QOL. Within the group of outpatients, participants with DSM-IV diagnoses had worse scores than those without. Participants with comorbidity had the worst QOL. Conclusions: It is concluded that QOL scores are negatively related to both the presence and the severity of psychopathology, and that the presence of a personality disorder plays a role in subjectively experienced QOL.

scholarly journals Development and psychometric properties of a disease-specific quality of life questionnaire for adult patients with growth hormone deficiency

2001 ◽  
pp. 255-265 ◽  
Author(s):  
P Herschbach ◽  
G Henrich ◽  
CJ Strasburger ◽  
H Feldmeier ◽  
F Marin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
Life Satisfaction ◽  
Adult Patients ◽  
Hormone Deficiency ◽  
Life Questionnaire ◽  
Cultural Backgrounds ◽  
Gh Replacement ◽  
Disease Specific

BACKGROUND: Adults with growth hormone (GH) deficiency (GHD) may experience physical and psychological disturbances, which can affect their quality of life (QOL). OBJECTIVES: To develop and validate a disease-specific module from the previously published QOL measure Questions on Life Satisfaction Modules (QLS(M)): the QLS(M)-H that specifically addressed the needs of patients with hypopituitarism. A second aim was for the questionnaire to be applicable across different cultural backgrounds in order to evaluate the efficacy of therapy in large, international clinical trials, thus providing additional clinical endpoints for these studies. DESIGN: A preliminary German language version of the QLS(M)-H was developed from 26 semi-structured interviews of adults with GHD. The questionnaire was then independently translated into five other languages and applied in open, non-controlled, multicentre, longitudinal studies to patient (n=717) and normative populations (n=2700). METHODS: A revised, nine-item version of the questionnaire was developed, based on previously defined criteria, and was evaluated for reliability and validity. Sensitivity to detect changes after GH replacement was also assessed. RESULTS: The 16 items of the preliminary questionnaire were reduced to nine items on the basis of the correlation of items/factors from initial patient interviews. Psychometric analysis revealed the reliability of the nine-item scale. The Cronbach's alpha scores ranged from 0.81 to 0.89 and the test-retest correlations ranged from 0.76 to 0.88, all of which indicate reliability over time. Mean scores increased significantly during GH replacement therapy, with observed changes greater than those seen with the non-specific modules of the QLS(M), indicating the sensitivity of the scale. CONCLUSIONS: The QLS(M)-H questionnaire is concise, easy to complete, and can be effectively applied across different cultural backgrounds. Psychometric evaluation of the questionnaire reveals that it is a valid, reliable and sensitive tool useful for assessing impaired life satisfaction in adult patients with GHD and also for monitoring the efficacy of GH therapy.

scholarly journals Growth hormone deficiency and replacement in hypopituitary patients previously treated for acromegaly or Cushing's disease

2002 ◽  
pp. 67-74 ◽  
Author(s):  
U Feldt-Rasmussen ◽  
R Abs ◽  
BA Bengtsson ◽  
H Bennmarker ◽  
M Bramnert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Growth Hormone ◽  
Cushing’S Disease ◽  
Cushing's Disease ◽  
Research Database ◽  
Serum Concentrations ◽  
Gh Replacement ◽  
Previously Treated

OBJECTIVE: To compare baseline characteristics in adult patients with growth hormone (GH) deficiency (GHD) who had previously been treated for Cushing's disease or acromegaly with data from patients with GHD of other aetiologies. To study the effects of GH therapy in those patients who had completed at least 6 months of GH replacement. DESIGN: Data from a large outcomes research database (KIMS (Pharmacia International Metabolic Database)). METHODS: 135 patients were identified with previous Cushing's disease, 40 had had acromegaly, and 1392 had GHD of other aetiologies. The number of additional hormone deficiencies, and the mean age of the patients were similar in the three groups. Similar proportions of patients in each group were treated using surgery, but radiotherapy was used more often in patients with acromegaly than those with other diagnoses. RESULTS: At baseline, the prevalence of diabetes mellitus and hypertension were significantly higher in the group treated for Cushing's disease, and the prevalence of stroke was significantly higher in the group treated for acromegaly. The incidence of coronary heart disease and claudication were similar in all three groups. Patients treated for Cushing's disease had lower bone mineral density and suffered fractures more often than other GHD adults. Body mass index, waist-hip ratio, serum concentrations of lipids and standard deviation scores of serum concentrations of insulin-like-growth factor-I were similar in the three groups. The dose of GH administered was comparable in the three groups and the effects of GH replacement on waist circumference, blood pressure and quality of life were also similar across the groups. The numbers and types of adverse events reported were not different between the groups. CONCLUSIONS: These data suggest that the characteristics of patients in these diagnostic groups depend on the primary disease which resulted in GHD, and that the clinical expression of GHD does not differ between the groups. Patients with previous hypercortisolism showed more long-term effects of their disease, such as diabetes mellitus, hypertension and fractures. A benefit from GH replacement was evident in patients previously treated for acromegaly and Cushing's disease particularly in relation to quality of life.

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