{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:43:32Z","timestamp":1790279012838,"version":"4.1.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009032","name":"Pfizer UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The acromegaly-associated arthropathy (AcAA) is a determinant of long-term impaired quality of life. There are limited data assessing the impact of arthropathy, determinants of future arthropathy, and current management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicentre cross-sectional questionnaire study of arthropathy in 6 UK endocrine centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study incorporated questionnaires relating to distribution of arthralgia, severity of pain, and clinical management of AcAA. Demographics and laboratory data were extracted from medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 411 patients (210 female, median 60, IQR 50-69 years) and median 13 (IQR 6-22) years since diagnosis. Joint pain was reported by 82.5%, with 43.3% and 13.1% experiencing moderate and severe joint pain respectively. The most frequently affected joints were knees (54.7%), lower back (47.7%), hips (38.9%), and shoulders (38.6%). Two hundred and forty-seven (60.1%) were taking at least one analgesic, 137 (33.3%) at least 2 classes of analgesics. One hundred and nine (26.5%) patients had at least one joint injection (median 2, 1-20). Seventy (17.0%) had at least one joint prosthesis (median 2, 1-6), at median age 59 (32-82) years. A similar percentage (17.0%) had other forms of joint surgery. Patients aged \u226450 years experienced less pain, required fewer joint injections and less joint surgery, but a similar prevalence of analgesic use, with 36.4% and 10.3% reporting moderate or severe pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study therefore highlights the burden of arthropathy in patients with acromegaly, estimates the need for therapeutic interventions, and the impact on health services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag045","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:48:31Z","timestamp":1772628511000},"page":"413-421","source":"Crossref","is-referenced-by-count":1,"title":["Distribution, severity, and management of joint pain in patients with acromegaly"],"prefix":"10.1093","volume":"194","author":[{"given":"Nikolaos","family":"Kyriakakis","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1419-1324","authenticated-orcid":false,"given":"Megan","family":"Heague","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Hebden","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawaz","family":"Safdar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5038-0174","authenticated-orcid":false,"given":"David S","family":"McLaren","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]},{"name":"Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds , Leeds LS2 9JT ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto S","family":"Tresoldi","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham B15 2GW ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstie","family":"Lithgow","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham B15 2GW ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Urwyler","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham B15 2GW ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetna","family":"Varsani","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, EC1A 7BE , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahzad","family":"Akbar","sequence":"additional","affiliation":[{"name":"Department of Academic Diabetes and Endocrinology, Hull University Teaching Hospitals NHS Trust HU3 2PA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"McLoughlin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Salford Royal NHS Foundation Trust M6 8HD ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Adeniji","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Salford Royal NHS Foundation Trust M6 8HD ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Kearney","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Salford Royal NHS Foundation Trust M6 8HD ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, EC1A 7BE , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3544-2231","authenticated-orcid":false,"given":"Thozhukat","family":"Sathyapalan","sequence":"additional","affiliation":[{"name":"Department of Academic Diabetes and Endocrinology, Hull University Teaching Hospitals NHS Trust HU3 2PA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire E","family":"Higham","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Christie NHS Foundation Trust M20 4BX ,","place":["United Kingdom"]},{"name":"Division of Cancer Services, University of Manchester \u00a0 M20 4BX ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-0643","authenticated-orcid":false,"given":"Niki","family":"Karavitaki","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham B15 2TT ,","place":["United Kingdom"]},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham B15 2GW ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6730-6109","authenticated-orcid":false,"given":"Robert D","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust , Leeds LS9 7TF ,","place":["United Kingdom"]},{"name":"Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds , Leeds LS2 9JT ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"issue":"1","key":"2026033105164333200_lvag045-B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1210\/jc.2007-1191","article-title":"Mortality in acromegaly: a metaanalysis","volume":"93","author":"Dekkers","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"2026033105164333200_lvag045-B2","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1016\/S2213-8587(22)00244-3","article-title":"Acromegaly: pathogenesis, diagnosis, and management","volume":"10","author":"Fleseriu","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"11","key":"2026033105164333200_lvag045-B3","doi-asserted-by":"publisher","first-page":"3933","DOI":"10.1210\/jc.2014-2700","article-title":"Acromegaly: an endocrine society clinical practice guideline","volume":"99","author":"Katznelson","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026033105164333200_lvag045-B4","doi-asserted-by":"publisher","first-page":"e00158","DOI":"10.1002\/edm2.158","article-title":"Management of persistent acromegaly following primary therapy: the current landscape in the UK","volume":"3","author":"Kyriakakis","year":"2020","journal-title":"Endocrinol Diabetes Metab"},{"issue":"6","key":"2026033105164333200_lvag045-B5","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1111\/cen.13331","article-title":"Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: results from a 5-years prospective study","volume":"86","author":"Kyriakakis","year":"2017","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"5","key":"2026033105164333200_lvag045-B6","doi-asserted-by":"publisher","first-page":"2731","DOI":"10.1210\/jc.2004-2297","article-title":"Morbidity after long-term remission for acromegaly: persisting joint-related complaints cause reduced quality of life","volume":"90","author":"Biermasz","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026033105164333200_lvag045-B7","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3897\/folmed.65.e68278","article-title":"Association between pain, arthropathy and health-related quality of life in patients suffering from acromegaly. A cross-sectional study","volume":"65","author":"Alito","year":"2023","journal-title":"Folia Med (Plovdiv)"},{"issue":"3","key":"2026033105164333200_lvag045-B8","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.ghir.2010.02.003","article-title":"Clinical osteoarthritis predicts physical and psychological QoL in acromegaly patients","volume":"20","author":"Wassenaar","year":"2010","journal-title":"Growth Horm IGF Res"},{"issue":"3","key":"2026033105164333200_lvag045-B9","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1530\/EJE-08-0845","article-title":"High prevalence of arthropathy, according to the definitions of radiological and clinical osteoarthritis, in patients with long-term cure of acromegaly: a case-control study","volume":"160","author":"Wassenaar","year":"2009","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2026033105164333200_lvag045-B10","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1210\/jc.2003-031283","article-title":"Acromegalic axial arthropathy: a clinical case-control study","volume":"89","author":"Scarpa","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026033105164333200_lvag045-B11","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1210\/clinem\/dgaa747","article-title":"Progression of acromegalic arthropathy in long-term controlled acromegaly patients: 9 years of longitudinal follow-up","volume":"106","author":"Pelsma","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026033105164333200_lvag045-B12","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1210\/jcem.83.6.4865","article-title":"Reversibility of joint thickening in acromegalic patients: an ultrasonography study","volume":"83","author":"Colao","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026033105164333200_lvag045-B13","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1111\/j.1365-2265.1988.tb03686.x","article-title":"Arthropathy in acromegalic patients before and after treatment: a long-term follow-up study","volume":"28","author":"Dons","year":"1988","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"2026033105164333200_lvag045-B14","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1136\/ard.2010.131698","article-title":"Arthropathy in long-term cured acromegaly is characterised by osteophytes without joint space narrowing: a comparison with generalised osteoarthritis","volume":"70","author":"Wassenaar","year":"2011","journal-title":"Ann Rheum Dis"},{"issue":"5","key":"2026033105164333200_lvag045-B15","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1007\/s11102-019-00966-8","article-title":"Study group on motor disability in acromegaly of the Italian Society of Endocrinology. Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity","volume":"22","author":"Fatti","year":"2019","journal-title":"Pituitary"},{"issue":"2","key":"2026033105164333200_lvag045-B16","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1093\/ejendo\/lvad090","article-title":"Joint pain, physical function, and balance self-confidence in acromegaly versus nonfunctioning pituitary adenoma patients","volume":"189","author":"Title","year":"2023 2","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2026033105164333200_lvag045-B17","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1093\/ejendo\/lvaf047","article-title":"Musculoskeletal disease in acromegaly-a population-based registry study","volume":"192","author":"Rosendal","year":"2025 3","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2026033105164333200_lvag045-B18","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1530\/EJE-12-0147","article-title":"Progression of acromegalic arthropathy despite long-term biochemical control: a prospective, radiological study","volume":"167","author":"Claessen","year":"2012","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026033105164333200_lvag045-B19","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1007\/s11102-022-01233-z","article-title":"Clinical and radiographic assessment of peripheral joints in controlled acromegaly","volume":"25","author":"Pelsma","year":"2022","journal-title":"Pituitary"},{"issue":"7","key":"2026033105164333200_lvag045-B20","doi-asserted-by":"publisher","first-page":"2374","DOI":"10.1210\/jc.2008-2393","article-title":"Pretreatment insulin-like growth factor-I concentrations predict radiographic osteoarthritis in acromegalic patients with long-term cured disease","volume":"94","author":"Biermasz","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026033105164333200_lvag045-B21","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1530\/EJE-16-1073","article-title":"Acromegalic arthropathy in various stages of the disease: an MRI study","volume":"176","author":"Claessen","year":"2017","journal-title":"Eur J Endocrinol"},{"issue":"12","key":"2026033105164333200_lvag045-B22","doi-asserted-by":"publisher","first-page":"4671","DOI":"10.1210\/jc.2009-1172","article-title":"The exon-3 deleted growth hormone receptor polymorphism predisposes to long-term complications of acromegaly","volume":"94","author":"Wassenaar","year":"2009","journal-title":"J Clin Endocrinol Metab"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejendo\/advance-article-pdf\/doi\/10.1093\/ejendo\/lvag045\/67240788\/lvag045.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/194\/3\/413\/67240788\/lvag045.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/194\/3\/413\/67240788\/lvag045.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:16:46Z","timestamp":1774948606000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/194\/3\/413\/8506912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ejendo\/lvag045","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]}}}