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Adult Growth Hormone Deficiency

Genotropin® treatment in adult GHD has been shown to:

  • Reduce cardiovascular risk factors and mortality1-3
  • Improve physical performance4,5
  • Reverse unfavourable changes in body composition2
  • Increase BMD and BMC6,7
  • Improve QoL and reduce healthcare consumption8,9
  • Be of benefit in elderly patients (<65 years of age) with severe GHD10

Genotropin® therapy reduces cardiovascular risk and mortality1,2,3,13,14

  • Therapy reduces vascular risk factors1-3
     
  • Treatment has been shown to improve lipid parameters, decrease total and LDL cholesterol and increase HDL cholesterol13
     
  • Mortality rates have been shown to be normalised with treatment in adult GHD14

Genotropin® therapy improves physical performance5,6,15

  • Improved muscle strength has been observed following GH therapy5
  • Significantly improved exercise performance and capacity are associated with somatropin GH treatment4,6,15
  • Therapy significantly improves LVEF at peak exercise4,15

Genotropin® reverses unfavourable changes in body composition with treatment2,8

  • GH therapy reduces fat mass and increases lean body mass2
    • Decreases waist circumference8
    • Improves waist to hip ratio8

Genotropin® therapy increases BMD and BMC1,6,7

  • Increases BMC and net BMD with long-term GH therapy1,6
     
  • Sustained increase in BMC and BMD at weight bearing sites is stimulated by long-term somatropin therapy6,7

Genotropin® improves QoL and reduces healthcare consumption8,9

  • Improved QoL during the first year of treatment with GH (maintained during second year of treatment)8,9
     
  • Reduced healthcare consumption, including the number of days spent in hospital and the number of doctor visits8,9

In a study,9 2 years of GH therapy resulted in:

  • A 63% reduction in the number of days of sick leave (P<0.0004)
     
  • An 83% reduction in the number of days spent in hospital (P<0.0001)
     
  • A reduction in the number of doctor visits (P<0.05)

Elderly patients (>65 years of age) can benefit from GH treatment10

  • Beneficial effects of GH replacement are observed in elderly patients with severe organic growth deficiency16
     
  • In KIMS patients, 6 months of GH therapy resulted in improvements in waist circumference and waist to hip ratio, diastolic BP, QoL, and total and LDL cholesterol levels8,9
     
  • Treatment goals can be achieved using lower doses compared with doses required in younger adults, which is in line with the observed physiological decrease in GH secretion in adults >60 years of age17

Adverse events of replacement therapy in adults with GHD (Clinical Trials)6

   

   

Adapted from Genotropin. Local product document. 2022. LPDSOM052020.

   

   

*In general, these adverse effects are mild to moderate, arise within the first months of treatment and subside spontaneously or with dose reduction. The incidence of these adverse effects is related to the administered dose, the age of the patients and possibly inversely related to the age of the patients at the onset of GH deficiency.
Transient injection site reactions in children have been reported.
Clinical significance is unknown.

   

ADR, adverse drug reaction; BMC, bone marrow cell; BMD, bone mineral density; GH, growth hormone; GHD, growth hormone deficiency; HDL, high-density lipoprotein; KIMS, Pfizer International Metabolic Database; LDL, low-density lipoprotein; LVEF, left ventricular ejection fraction; QoL, quality of life.

   

References:

Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML; Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. [Published correction appears in J Clin Endocrinol Metab. 2021;106(7):e2849]. J Clin Endocrinol Metab. 2006;91(5):1621-1634.Maison P, Griffin S, Nicoue-Beglah M, Haddad N, Balkau B, Chanson P. Impact of growth hormone (GH) treatment on cardiovascular risk factors in GH-deficient adults: a metaanalysis of blinded, randomized, placebo-controlled trials. J Clin Endocrinol Metab. 2004;89(5):2192-2199.McCallum RW, Sainsbury CA, Spiers A, et al. Growth hormone replacement reduces C-reactive protein and large-artery stiffness but does not alter endothelial function in patients with adult growth hormone deficiency. Clin Endocrinol (Oxf). 2005;62(4):473-479.Widdowson WM, 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):4413-4417.Götherström G, Bengtsson BA, Bosaeus I, Johannsson G, Svensson J. A 10-year, prospective study of the metabolic effects of growth hormone replacement in adults. J Clin Endocrinol Metab. 2007;92(4):1442-1445.Genotropin. Local product document. Pfizer; 2022. Version LPDSOM052020.Bravenboer N, Holzmann PJ, ter Maaten JC, Stuurman LM, Roos JC, Lips P. Effect of long-term growth hormone treatment on bone mass and bone metabolism in growth hormone-deficient men. J Bone Miner Res. 2005;20(10):1778-1784.Gutiérrez LP, Kołtowska-Häggström M, Jönsson PJ, et al. Registries as a tool in evidence-based medicine: example of KIMS (Pfizer International Metabolic Database). Pharmacoepidemiol Drug Saf. 2008;17(1):90-102.Saller B, Mattsson AF, Kann PH, et al. Healthcare utilization, quality of life and patient-reported outcomes during two years of GH replacement therapy in GH-deficient adults--comparison between Sweden, The Netherlands and Germany. Eur J Endocrinol. 2006;154(6):843-850.Monson JP, Abs R, Bengtsson BA, et al. Growth hormone deficiency and replacement in elderly hypopituitary adults. KIMS Study Group and the KIMS International Board. Pharmacia and Upjohn International Metabolic Database. Clin Endocrinol (Oxf). 2000;53(3):281-289.NICE Guidance [TA64]. Human growth hormone (somatropin) in adults with growth hormone deficiency. Accessed here. Last accessed May 2022.Copinschi, G., Nedeltcheva, A., Leproult, R., Morselli, L.L., Spiegel, K., Martino, E., Legros, J.J., Weiss, R.E., Mockel, J. and Van Cauter, E., 2010. Sleep disturbances, daytime sleepiness, and quality of life in adults with growth hormone deficiency. The Journal of Clinical Endocrinology & Metabolism, 95(5), pp.2195-2202Verhelst, J., Abs, R., Vandeweghe, M., Mockel, J., Legros, J.J., Copinschi, G., Mahler, C., Velkeniers, B., Vanhaelst, L., Van Aelst, A. and De Rijdt, D., 1997. Two years of replacement therapy in adults with growth hormone deficiency. Clinical endocrinology, 47(4), pp.485-494.Thomas JDJ, Monson JP. Adult GH deficiency throughout lifetime. Eur J Endocrinol. 2009;161(suppl 1):S97-S106.Colao A, di Somma C, Cuocolo A, et al. Improved cardiovascular risk factors and cardiac performance after 12 months of growth hormone (GH) replacement in young adult patients with GH deficiency. J Clin Endocrinol Metab. 2001;86(5):1874-1881.Drake WM, Coyte D, Camacho-Hübner C, et al. Optimizing growth hormone replacement therapy by dose titration in hypopituitary adults. J Clin Endocrinol Metab. 1998;83(11):3913-3919.Ho KKY; 2007 GH Deficiency Consensus Workshop Participants. Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia. Eur J Endocrinol. 2007;157(6):695-700.

   

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