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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1516899

Impact of Strict IGF1 Control on Quality-of-Life Scores in Patients with Acromegaly

Provisionally accepted
Chaitanya Gandhi Chaitanya Gandhi 1Marie-Claire Denis Marie-Claire Denis 2Daniel Holmes Daniel Holmes 3Juan Rivera Juan Rivera 4Stan Van Uum Stan Van Uum 5Shereen Ezzat Shereen Ezzat 6Constance Chik Constance Chik 1*
  • 1 University of Alberta, Edmonton, Canada
  • 2 Centre Hospitalier Universitaire de Québec, Québec, Quebec, Canada
  • 3 St. Paul's Hospital (Vancouver), Vancouver, British Columbia, Canada
  • 4 McGill University, Montreal, Quebec, Canada
  • 5 Western University, London, Ontario, Canada
  • 6 Princess Margaret Cancer Centre, University Health Network (UHN), Toronto, Ontario, Canada

The final, formatted version of the article will be published soon.

    Objective: Examine, in a real-world setting, whether strict normalization of modestly elevated insulin-like growth factor 1(IGF1) results in clinical and health-related quality of life benefits in patients with acromegaly using an open-label, non-randomized, 6-month prospective interventional study.In patients with acromegaly and modest IGF1 elevation, strict IGF1 control was achieved by addition or dose escalation of pegvisomant. Clinical and biochemical parameters were assessed at baseline, 1 and 3 months for pegvisomant dose titration, and at 6 months. The Patient-Assessed Acromegaly Symptom Questionnaire (PASQ), the Acromegaly Quality of Life questionnaire (AcroQoL) and the Acromegaly Disease Activity Tool (ACRODAT®) were completed at baseline and at 6 months.Results: Ten patients (8 males) with mean age of 50.7 years participated in the study. All patients had a macroadenoma and nine had prior transsphenoidal surgeries. At time of screening, six patients were on a somatostatin analog, two on pegvisomant, and two on pegvisomant and a somatostatin analog. After six months of dose escalation or the addition of pegvisomant, IGF1 decreased from 1.22 ± 0.14 to 0.87 ± 0.20 times the upper limit of normal (p=0.001). PASQ score decreased by 3.5 (p=0.02) and the ACRODAT® overall status decreased by 50.5 (p=0.001); however, there was no difference in the AcroQoL score. Hemoglobin A1c and liver enzymes did not differ and repeat MRI of the sella at 6 months showed no change.In this pilot study, stricter control of modest IGF1 elevations led to symptomatic improvement as measured by the PASQ score. These findings prompt larger prospective trials.

    Keywords: Acromegaly, quality-of-life, pegvisomant, Insulin-like growth factor 1, Clinical Trial

    Received: 25 Oct 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Gandhi, Denis, Holmes, Rivera, Van Uum, Ezzat and Chik. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Constance Chik, University of Alberta, Edmonton, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.