Abstract
PurposePatients receiving treatment for acromegaly often experience significant associated comorbidities for which they are prescribed additional medications. We aimed to determine the real-world prevalence of comorbidities and concomitant medications in patients with acromegaly, and to investigate the association between frequency of comorbidities and number of concomitantly prescribed medications.MethodsAdministrative claims data were obtained from the IBM® MarketScan® database for a cohort of patients with acromegaly, identified by relevant diagnosis codes and acromegaly treatments, and a matched control cohort of patients without acromegaly from January 2010 through April 2020. Comorbidities were identified based on relevant claims and assessed for both cohorts.ResultsOverall, 1175 patients with acromegaly and 5875 matched patients without acromegaly were included. Patients with acromegaly had significantly more comorbidities and were prescribed concomitant medications more so than patients without acromegaly. In the acromegaly and control cohorts, respectively, 67.6% and 48.4% of patients had cardiovascular disorders, the most prevalent comorbidities, and 89.0% and 68.3% were prescribed > 3 concomitant medications (p < 0.0001). Hypopituitarism and hypothalamic disorders, sleep apnea, malignant neoplasms and cancer, and arthritis and musculoskeletal disorders were also highly prevalent in the acromegaly cohort. A moderate, positive correlation (Spearman correlation coefficient 0.60) was found between number of comorbidities and number of concomitant medications in the acromegaly cohort.ConclusionCompared with patients without acromegaly, patients with acromegaly have significantly more comorbidities and are prescribed significantly more concomitant medications. Physicians should consider the number and type of ongoing medications for individual patients before prescribing additional acromegaly treatments.
Highlights
Is generally caused by a growth hormone (GH)secreting pituitary adenoma, resulting in GH excess and elevated insulin-like growth factor 1 (IGF-1) levels [1,2,3]
A total of 52 patients were included in the sub-cohort of patients with acromegaly receiving anticoagulants; 1123 patients were included in the sub-cohort of patients with acromegaly not Acromegaly cohort Control cohort (N = 1175)
CI confidence interval, SD standard deviation receiving anticoagulants; 131 patients without acromegaly were included in the control cohort of patients receiving anticoagulants; and 5744 patients without acromegaly were included in the control cohort of patients not receiving anticoagulants
Summary
Is generally caused by a growth hormone (GH)secreting pituitary adenoma, resulting in GH excess and elevated insulin-like growth factor 1 (IGF-1) levels [1,2,3]. There is an approximately two-fold excess in mortality in patients with uncontrolled acromegaly compared with the general population [2, 15, 16], as well as an increased cost associated with comorbidity treatment and reduced quality of life [17]. In addition to therapies targeting GH and IGF-1 oversecretion, patients often require treatment for acromegaly-related comorbidities, resulting in prescription of multiple medications [19]. Different routes of medication administration are associated with respective advantages and disadvantages related to ease of administration, medication absorption, and reactions with other medications [28, 29] Taking all these factors into account, it is important for physicians to consider the quantity and form of medications a patient is already receiving when prescribing additional treatments
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