Year: 2026
Type: article
Abstract: Objective Cushing’s syndrome (CS) is associated with marked impairment in quality of life (QoL). This analysis aimed to comprehensively describe QoL impairment in participants of the PROMPT study using two validated instruments: the CushingQoL and the Tübingen Cushing’s Disease Quality of Life Inventory (CD-25). Methods Cross-sectional analysis used baseline questionnaires from PROMPT (NCT02297945), a prospective study of metyrapone in 49 adults with confirmed endogenous CS. Item- and domain-level analyses were conducted for the CushingQoL (0-100; higher = better QoL) and CD-25 (0-100; higher = worse QoL). Subgroups: sex (15 males, 34 females) and biochemical UFC severity (31 moderate and 16 severe). Results Patients reported substantial impairment in QoL. The mean CushingQoL score was 41.2 (95%CI 35.6-46.7), with greater physical (36.8) than psychosocial (45.5) burden. The CD-25 score was 39.8 (95%CI 32.7-46.9), with bodily restrictions (48.6) and eating behaviour (44.7) most severely affected. Worry about future health (75.5%) and physical appearance (73.5%) were the most prevalent individual concerns. The two instruments were strongly inversely correlated (r= −0.81, p<0.001). Females reported clinically worse psychosocial QoL compared with males (CushingQoL psychosocial: 41.7 vs 54.2, −12.2 points; CD-25 depression: 39.5 vs 26.9, + 12.6 points), despite similar biochemical severity. No meaningful differences in overall QoL scores were observed between patients with moderate versus severe hypercortisolism. Conclusions Uncontrolled CS is associated with profound multidomain QoL impairment dominated by psychological distress, largely independent of biochemical disease severity. Women reported clinically meaningful worse psychosocial outcomes than men. Disease-specific, item-level QoL assessment may add information not captured by biochemical parameters in patients with active CS.
Source: Frontiers in Endocrinology
Authors: Carla Scaroni, Lynnette K. Nieman, Marco Boscaro, Timo Deutschbein, Emese Mezôsi, Natacha Driessens, Carmen E. Georgescu, Marcin Motyka, Alicja Hubalewska-Dydejczyk, Barbara Jarzab, Dominique Maiter, Martin Reincke, Paola Loli, Benedetta Zampetti, Aysegul Atmaca, Corin Badiu, Albert Beckers, Marek Bolanowski, Francesco Cavagnini, Nicole Unger, Roberta Giordano, Felicia Alexandra Hanzu, Massimo Terzolo, Arnau Domenech, Myriam Bou Nader, Ninet Sinaii, Judit Tőke, Miklós Tóth
Institutions: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, University of Würzburg, Universitätsklinikum Würzburg, Medicover, Université Libre de Bruxelles, Erasmus Hospital, Iuliu Hațieganu University of Medicine and Pharmacy, Szpital Uniwersytecki w Krakowie, Jagiellonian University, The Maria Sklodowska-Curie National Research Institute of Oncology, UCLouvain, LMU Klinikum, Ludwig-Maximilians-Universität München, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Ondokuz Mayıs University, Carol Davila University of Medicine and Pharmacy, Institutul Național de Endocrinologie C.I. Parhon, University of Wrocław, Wroclaw Medical University, IRCCS Istituto Auxologico Italiano, Essen University Hospital, University of Turin, Hospital Clínic de Barcelona, Universitat de Barcelona, Ospedale San Luigi Gonzaga, Esteve (Spain), National Institutes of Health Clinical Center, Semmelweis University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funder: Esteve Pharmaceuticals
OpenAlex ID: W7225340179