Acromegaly Disease Activity According to ACRODAT®, in Spain: ACROVAL Study

Objectives: To evaluate disease activity status using the Acromegaly Disease Activity Tool (ACRODAT ® ) in a cohort of Spanish acromegaly patients, to assess the relationship between the level of disease activity according to both ACRODAT ® and the physicians’ clinical evaluation, and to study the potential discrepancies in the perception of symptoms between physicians and patients. Design: Multicenter, observational, descriptive and cross-sectional study. Methods: : Disease activity was assessed in adult patients with acromegaly under pharmacological treatment during at least 6 months using ACRODAT ® . Results: : According to ACRODAT ® , 48.2%, 31.8% and 20.0% of a total of 111 patients were classified as having a stable disease (S), mild disease activity (M-DA) and significant disease activity (S-DA) respectively. ACRODAT ® classification of disease activity significantly correlated with physicians’ opinion, with a moderate inter-rater agreement and a specificity of 92.45% (PPV=86.21%). No correlation was found between IGF-1 levels and severity of symptoms or quality of life (QoL). A decision to take clinical action was significantly more frequent in S-DA and M-DA patients than S patients but no action was taken on 5 (22.7%) and 27 (77.1%) S-DA and M-DA patients, respectively Conclusions: : ACRODAT ® detected disease activity in 51.8% of patients. Interestingly, although M-DA and S-DA patients were likely to be in the process of being controlled, action was not always taken on these patients. ACRODAT ® is a validated and highly specific tool that may be useful to routinely monitor acromegaly and to identify patients with non-obvious disease activity by incorporating “patient-centered” parameters like symptoms and QoL to the clinical evaluation of acromegaly.