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Worse Health‐Related Quality of Life at long‐term follow‐up in patients with Cushing's disease than patients with cortisol producing adenoma. Data from the ERCUSYN
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International audience. Summary Objective Hypercortisolism in Cushing's syndrome ( CS ) is associated with impaired health‐related quality of life ( HRQ oL), which may persist despite remission. We used the data entered into the European Registry on Cushing's syndrome ( ERCUSYN ) to evaluate if patients with CS of pituitary origin ( PIT ‐ CS ) have worse HRQ oL, both before and after treatment than patients with adrenal causes ( ADR ‐ CS ). Methods Data from 595 patients (492 women; 83%) who completed the CushingQoL and/or EQ ‐5D questionnaires at baseline and/or following treatment were analysed. Results At baseline, HRQ oL did not differ between PIT ‐ CS (n = 293) and ADR ‐ CS (n = 120) on both EuroQoL and CushingQoL. Total CushingQoL score in PIT ‐ CS and ADR ‐ CS was 41 ± 18 and 44 ± 20, respectively ( P = .7). At long‐time follow‐up (>1 year after treatment) total CushingQoL score was however lower in PIT ‐ CS than ADR ‐ CS (56 ± 20 vs 62 ± 23; P = .045). In a regression analysis, after adjustment for baseline age, gender, remission status, duration of active CS , glucocorticoid dependency and follow‐up time, no association was observed between aetiology and HRQ oL. Remission was associated with better total CushingQoL score ( P < .001), and older age at diagnosis with worse total score ( P = .01). Depression at diagnosis was associated with worse total CushingQoL score at the last follow‐up ( P < .001). Conclusion PIT ‐ CS patients had poorer HRQ oL than ADR ‐ CS at long‐term follow‐up, despite similar baseline scoring. After adjusting for remission status, no interaetiology differences in HRQ oL scoring were found. Age and presence of depression at diagnosis of CS may be potential predictors of worse HRQ oL regardless of CS aetiology.
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