Ten-Year Change in Quality of Life in Patients with Childhood and Adult Onset Growth Hormone Deficiency in the Hypopituitary Control and Complications Study (HypoCCS)

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 130-162-Neuroendocrinology
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-149
Daojun Mo*1, Werner F. Blum2, Myriam Rosilio3, Andrea F. Attanasio4, Susan M. Webb5, Richard J. Ross6 and Christian J. Strasburger7
1Eli Lilly and Company, Indianapolis, IN, 2Eli Lilly and Company, Bad Homburg, Germany, 3Lilly France, Neuilly sur Seine, France, 4Cascina Del Rosone, Agliano Terme, Italy, 5Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII and Universitat Autňnoma de Barcelona (UAB), Barcelona, Spain, 6University of Sheffield, Sheffield, United Kingdom, 7Charité-Universitätsmedizin, Campus Mitte, Berlin, Berlin, Germany
Background: Previous studies showed that impaired quality of life (QoL) in adult patients with GH deficiency (GHD) improved within a few months after initiating GH replacement, and the improvement was sustained over a few years (1,2). However, longer follow-up data are lacking.

Objective:To assess QoL over 10 years in adult patients with childhood onset (CO) and adult onset (AO) GHD who received GH replacement in HypoCCS.   

Patients and methods: 1646 GH-treated patients with AO GHD [age (yr): 49.2 ± 12.4 (mean ± SD), 51% male] and 361 patients with CO GHD (28.2 ± 9.0, 55% male) who had available QoL data at study entry were included in this analysis. QoL was measured by a disease-specific instrument, Questions on Life Satisfaction-Hypopituitarism (QLS-H), in these patients from 7 countries (France, Germany, Italy, the Netherlands, Spain, UK and the USA), where validated questionnaires and normative data for calculation of Z-scores were available (3,4). ANOVA was used for Z-score comparison.   

Results: At study entry, patients had diminished QoL. AO patients had a lower Z-score than CO (-1.5 ± 1.7 vs. -0.9 ± 1.3, P <.001), and female (F) patients lower than male (M) (-1.7 ± 1.7 vs. -1.2 ± 1.5, P <.001). The largest QoL improvements were seen in the first year (yr): Z-score increased by 0.7 ± 1.4 for AO (P <.001), 0.5 ± 1.2 for CO (P <.001), 0.8 ± 1.5 for F (P <.001), and 0.6 ± 1.2 for M (P <.001). The initial improvement from study entry remained statistically significant throughout 10 yrs for AO, yrs of 1 to 7 and 9 for CO, yrs 1 to 10 for M, and yrs 1 to 9 for F (P <.05). The improvement was observed in all other yrs (yrs of 8 and 10 for CO and yr 10 for F), but did not reach statistical significance possibly due to small numbers of patients with available Z-scores in the later years. The mean Z-scores during follow up years varied from -0.9 to -0.8 in AO patients, -0.5 to 0.2 in CO patients, -1.2 to -0.8 in females, and -0.8 to -0.5 in males. For AO patients, the Z-scores for females (range -1.2 to -1.0) were significantly lower than for males (-0.8 to -0.5) in the first 9 yrs (P<.05).

Conclusion: These data suggest that GH replacement maintains an improvement of QoL toward normality over a period of up to 10 years.

(1) Koltowska-Häggström M et al. , Eur J Endocrinol. 2006;155(1):109-19 (2) Rosilio M et al. J Clin Endocrinol Metab. 2004;89(4):1684-93 (3) Herschbach P et al. Eur J Endocrinol. 2001;145:255–265 (4) Blum WF et al. J Clin Endocrinol Metab. 2003;88:4158

Disclosure: DM: Employee, Eli Lilly & Company, Employee, Eli Lilly & Company. WFB: Employee, Eli Lilly & Company, Employee, Eli Lilly & Company. MR: Employee, Eli Lilly & Company, Employee, Eli Lilly & Company. RJR: Founder, Diurnal. Nothing to Disclose: AFA, SMW, CJS

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: Eli Lilly and Company