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Adrenalectomy, MRA improve QoL in primary aldosteronism

10 Feb 2018

Both surgical (adrenalectomy) and medical (mineralocorticoid receptor antagonists [MRA]) treatments improve quality of life (QoL) in primary aldosteronism (PA), which highlights the importance of identifying these patients, according to a recent study.

In addition, better improvement in QoL is observed after adrenalectomy for suspected aldosterone-producing adenoma (APA) than after initiation of medical treatment for suspected bilateral adrenal hyperplasia (BAH). APA and BAH are two subtypes of PA.

A total of 184 patients with PA were included in this posthoc comparative effectiveness study within the Subtyping Primary Aldosteronism: A Randomized Trial Comparing Adrenal Vein Sampling and Computed Tomography Scan (SPARTACUS) trial. QoL was assessed at baseline and 6- and 1-year follow-up using two validated questionnaires: RAND 36-item Health Survey (RAND SF-36) and European Quality of Life‒5 Dimensions (EQ-5D).

Patients with PA, compared with the general population, had lower scores in seven of eight RAND SF-36 and both summary scores, as well as in three of five EQ-5D dimensions and the visual analogue scale at baseline.

Adrenalectomy demonstrated larger beneficial effects than those for MRAs for seven RAND SF-36 subscales, both summary scores and health change. For the EQ-5D, there was a difference in favour of adrenalectomy in two dimensions and the visual analogue scale.

In both surgical and medical treatments, most differences in QoL exceeded the minimally clinically important difference. After 1 year, almost all QoL measures had normalized for patients who underwent adrenalectomy. For those on MRAs, most QoL measures had improved but not all to the level of the general population.

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Most Read Articles
Roshini Claire Anthony, 4 days ago

Individuals with moderate-to-severe plaque psoriasis may reap better long-term improvements in the severity of their condition when treated with guselkumab over secukinumab, according to findings of the phase III ECLIPSE* trial presented at the recent Inflammatory Skin Disease Summit (ISDS 2018) held in Vienna, Austria.

Jairia Dela Cruz, 11 Jan 2019
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
3 days ago
Discontinuing the use of tyrosine kinase inhibitors (TKIs) in the treatment of patients with chronic myeloid leukaemia appears to be feasible in real-life clinical practice in the context of close molecular monitoring, a study reports.
4 days ago
There appears to be no clear link between pornography use, even at problematic levels, and erectile dysfunction, a recent US study has shown.