Low prevalence of neuropathic-like pain symptoms in long-term controlled acromegaly

Trigt, V.R. van; Pelsma, I.C.M.; Kroon, H.M.; Pereira, A.M.; Meulen, C. van der; Kloppenburg, M.; ... ; Claessen, K.M.J.A. (2021)

Article / Letter to editor

Purpose Pain is a common symptom of acromegaly, impairing health-related quality of life (HR-QoL) significantly despite long-term disease remission. Neuropathic-like pain (NP-like) symptoms are invalidating, with great impact on HR-QoL. Studies characterizing or investigating the etiology of pain in acromegaly are scarce. Therefore, we aimed to assess NP-like symptoms in a cohort of controlled acromegaly patients. Methods Forty-four long-term controlled acromegaly patients (aged 62.6 +/- 12.6 years; 56.8% female) were included in this cross-sectional study. NP-like symptoms were assessed using the validated painDETECT questionnaire. Patients were divided in three probability-based NP-like symptoms categories based on the total score (range 0-35): unlikely (<= 12), indeterminate (13-18) and likely (>= 19). HR-QoL (physical component score (PCS), and mental component score (MCS)), and self-reported pain were assessed using Short Form-36 (SF-36). Potential risk factors were determined using linear regression analyses. Results Self-reported pain was reported by 35 patients (79.5%). Likely NP-like symptoms were present in 4/44 patients (9.1%), and indeterminate NP-like symptoms in 6/44 patients (13.6%). All patients with likely NP-like symptoms were female. Higher painDETECT scores were negatively associated with HR-QoL (PCS: r = - 0.46, P = 0.003; MCS: r = - 0.37, P = 0.018), and SF-36 pain scores (r = - 0.63, P < 0.0001). Female sex was a risk factor for NP-like symptoms. Conclusions Pain was prevalent in controlled acromegaly patients, whereas NP-like symptoms were relatively infrequent, and only observed in females. NP-like symptoms were associated with lower HR-QoL in acromegaly. Since specific analgesic therapy is available, awareness for characterization, increased understanding, and clinical trials regarding neuropathic pain identification and treatment in acromegaly patients are warranted.

• Acromegaly
• GH
• IGF-1
• Pain
• Neuropathic pain
• HR-QoL

• All authors: Trigt, V.R. van; Pelsma, I.C.M.; Kroon, H.M.; Pereira, A.M.; Meulen, C. van der; Kloppenburg, M.; Biermasz, N.R.; Claessen, K.M.J.A.
• Date: 2021-10-23
• Journal: Pituitary
• Volume: 25
• Pages: 229 - 237
• DOI: doi:10.1007/s11102-021-01190-z
• Link: https://link.springer.com/content/pdf/10.1007/s11102-021-01190-z.pdf