Update on GH Therapy in Adults

Overview

Journal F1000Res

Specialties Biomedical Engineering
Science

Date 2017 Dec 12

PMID 29225782

Citations 12

Authors

Cesar Luiz Boguszewski

Affiliations

Soon will be listed here.

Abstract

Over the last three decades, short- and long-term observational studies, clinical trials, systematic reviews, and meta-analyses have provided relevant information on the efficacy and safety of growth hormone (GH) replacement therapy in adults with GH deficiency (AGHD). The knowledge acquired during this time has been compiled into different guidelines that offer clinicians an evidence-based, practical approach for the management of AGHD. There are, however, still open questions in some key areas in which recommendations are supported by only moderate or weak evidence. In the last recent years, the development of long-acting GH preparations has created new therapeutic possibilities by decreasing injection frequency, improving adherence and thereby potentially maximizing clinical outcomes. The aims of this review are to advance our understanding on the diagnosis and treatment of AGHD and to present an update and future perspectives on the use of long-acting GH preparations.

Citing Articles

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Yuen K, Blevins L, Clemmons D, Faurby M, Hoffman A, Kelepouris N Clinicoecon Outcomes Res. 2024; 16:133-147.

PMID: 38476578 PMC: 10929649. DOI: 10.2147/CEOR.S445495.

Somatropin therapy in italian adults with growth hormone deficiency.

Pricci F, Rotondi D, Villa M, Valerio A, Agazio E, Roazzi P BMC Endocr Disord. 2022; 22(1):52.

PMID: 35241041 PMC: 8895664. DOI: 10.1186/s12902-022-00960-5.

Effect of Weekly Long-Acting Growth Hormone Replacement Therapy Compared to Daily Growth Hormone on Children With Short Stature: A Meta-Analysis.

Ma L, Li L, Pan W, Huang C, Liu L, Zhang X Front Endocrinol (Lausanne). 2021; 12:726172.

PMID: 34912293 PMC: 8667176. DOI: 10.3389/fendo.2021.726172.

Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism.

Garmes H, Boguszewski C, Miranda P, Martins M, da Silva S, Abucham Filho J Arch Endocrinol Metab. 2021; 65(2):212-230.

PMID: 33905631 PMC: 10065316. DOI: 10.20945/2359-3997000000335.

Usefulness and Potential Pitfalls of Long-Acting Growth Hormone Analogs.

Yuen K, Miller B, Boguszewski C, Hoffman A Front Endocrinol (Lausanne). 2021; 12:637209.

PMID: 33716988 PMC: 7943875. DOI: 10.3389/fendo.2021.637209.

References

Arwert L, Roos J, Lips P, Twisk J, Manoliu R, Drent M . Effects of 10 years of growth hormone (GH) replacement therapy in adult GH-deficient men. Clin Endocrinol (Oxf). 2005; 63(3):310-6. DOI: 10.1111/j.1365-2265.2005.02343.x. View

Yuen K, Tritos N, Samson S, Hoffman A, Katznelson L . AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY DISEASE STATE CLINICAL REVIEW: UPDATE ON GROWTH HORMONE STIMULATION TESTING AND PROPOSED REVISED CUT-POINT FOR THE GLUCAGON STIMULATION TEST IN THE DIAGNOSIS OF.... Endocr Pract. 2016; 22(10):1235-1244. DOI: 10.4158/EP161407.DSCR. View

Xue P, Wang Y, Yang J, Li Y . Effects of growth hormone replacement therapy on bone mineral density in growth hormone deficient adults: a meta-analysis. Int J Endocrinol. 2013; 2013:216107. PMC: 3652209. DOI: 10.1155/2013/216107. View

Ho K, Gibney J, Johannsson G, Wolthers T . Regulating of growth hormone sensitivity by sex steroids: implications for therapy. Front Horm Res. 2006; 35:115-128. DOI: 10.1159/000094314. View

Andujar-Plata P, Fernandez-Rodriguez E, Quinteiro C, Casanueva F, Bernabeu I . Influence of the exon 3 deletion of GH receptor and IGF-I level at diagnosis on the efficacy and safety of treatment with somatotropin in adults with GH deficiency. Pituitary. 2014; 18(1):101-7. DOI: 10.1007/s11102-014-0562-0. View

Molitch M, Clemmons D, Malozowski S, Merriam G, Vance M . Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(6):1587-609. DOI: 10.1210/jc.2011-0179. View

Tauber M, Moulin P, Pienkowski C, Jouret B, Rochiccioli P . Growth hormone (GH) retesting and auxological data in 131 GH-deficient patients after completion of treatment. J Clin Endocrinol Metab. 1997; 82(2):352-6. DOI: 10.1210/jcem.82.2.3726. View

Conceicao F, Da Costa E Silva A, Leal Costa A, Vaisman M . Glucagon stimulation test for the diagnosis of GH deficiency in adults. J Endocrinol Invest. 2004; 26(11):1065-70. DOI: 10.1007/BF03345251. View

Higham C, Johannsson G, Shalet S . Hypopituitarism. Lancet. 2016; 388(10058):2403-2415. DOI: 10.1016/S0140-6736(16)30053-8. View

10.

Barake M, Klibanski A, Tritos N . Effects of recombinant human growth hormone therapy on bone mineral density in adults with growth hormone deficiency: a meta-analysis. J Clin Endocrinol Metab. 2014; 99(3):852-60. DOI: 10.1210/jc.2013-3921. View

11.

Boguszewski C, Meister L, Zaninelli D, Radominski R . One year of GH replacement therapy with a fixed low-dose regimen improves body composition, bone mineral density and lipid profile of GH-deficient adults. Eur J Endocrinol. 2005; 152(1):67-75. DOI: 10.1530/eje.1.01817. View

12.

Gasco V, Caputo M, Lanfranco F, Ghigo E, Grottoli S . Management of GH treatment in adult GH deficiency. Best Pract Res Clin Endocrinol Metab. 2017; 31(1):13-24. DOI: 10.1016/j.beem.2017.03.001. View

13.

RABEN M . Growth hormone. 2. Clinical use of human growth hormone. N Engl J Med. 1962; 266:82-6 concl. DOI: 10.1056/NEJM196201112660207. View

14.

Melmed S . Idiopathic adult growth hormone deficiency. J Clin Endocrinol Metab. 2013; 98(6):2187-97. PMC: 3667267. DOI: 10.1210/jc.2012-4012. View

15.

Widdowson W, Gibney J . The effect of growth hormone replacement on exercise capacity in patients with GH deficiency: a metaanalysis. J Clin Endocrinol Metab. 2008; 93(11):4413-7. DOI: 10.1210/jc.2008-1239. View

16.

Boguszewski C, de Lacerda C, Lacerda Filho L, de Carvalho J, Boguszewski M . Reappraisal of serum insulin-like growth factor-I (IGF-1) measurement in the detection of isolated and combined growth hormone deficiency (GHD) during the transition period. Arq Bras Endocrinol Metabol. 2014; 57(9):709-16. DOI: 10.1590/s0004-27302013000900006. View

17.

Barbosa E, Palming J, Glad C, Filipsson H, Koranyi J, Bengtsson B . Influence of the exon 3-deleted/full-length growth hormone (GH) receptor polymorphism on the response to GH replacement therapy in adults with severe GH deficiency. J Clin Endocrinol Metab. 2008; 94(2):639-44. DOI: 10.1210/jc.2008-0323. View

18.

Alexopoulou O, Beguin C, De Nayer P, Maiter D . Clinical and hormonal characteristics of central hypothyroidism at diagnosis and during follow-up in adult patients. Eur J Endocrinol. 2004; 150(1):1-8. DOI: 10.1530/eje.0.1500001. View

19.

Allen D, Backeljauw P, Bidlingmaier M, Biller B, Boguszewski M, Burman P . GH safety workshop position paper: a critical appraisal of recombinant human GH therapy in children and adults. Eur J Endocrinol. 2015; 174(2):P1-9. PMC: 4674592. DOI: 10.1530/EJE-15-0873. View

20.

Bryant J, Loveman E, Chase D, Mihaylova B, Cave C, Gerard K . Clinical effectiveness and cost-effectiveness of growth hormone in adults in relation to impact on quality of life: a systematic review and economic evaluation. Health Technol Assess. 2003; 6(19):1-106. View