Quality of Life in Primary Aldosteronism: A Comparative Effectiveness Study of Adrenalectomy and Medical Treatment

The Journal of Clinical Endocrinology and Metabolism
Marieke VelemaSPARTACUS investigators

Abstract

In primary aldosteronism (PA), two subtypes are distinguished: aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH). In general, these are treated by adrenalectomy (ADX) and mineralocorticoid receptor antagonists (MRA), respectively. To compare the effects of surgical treatment and medical treatment on quality of life (QoL). Post hoc comparative effectiveness study within the Subtyping Primary Aldosteronism: A Randomized Trial Comparing Adrenal Vein Sampling and Computed Tomography Scan (SPARTACUS) trial. Twelve Dutch hospitals and one Polish hospital. Patients with PA (n = 184). ADX or MRAs. At baseline and 6-month and 1-year follow-up, we assessed QoL by two validated questionnaires: RAND 36-Item Health Survey 1.0 (RAND SF-36) and European Quality of Life-5 Dimensions (EQ-5D). At baseline, seven of eight RAND SF-36 subscales and both summary scores, as well as three of five EQ-5D dimensions and the visual analog scale, were lower in patients with PA compared with the general population, especially in women. The beneficial effects of ADX were larger than for MRAs for seven RAND SF-36 subscales, both summary scores, and health change. For the EQ-5D, we detected a difference in favor of ADX in two dimensio...Continue Reading

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Citations

Mar 14, 2019·Endocrine Connections·Marieke VelemaJaap Deinum
Jul 29, 2019·Current Cardiology Reports·Gregory L Hundemer
Apr 19, 2020·The Journal of Clinical Endocrinology and Metabolism·Paolo MulateroSilvia Monticone
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