Analysis of characteristics and outcomes by growth hormone treatment duration in adult patients in the Italian cohort of the Hypopituitary Control and Complications Study (HypoCCS)

V Rochira,C Lubrano,C Scaroni,G Mossetto,S M Corsello,G Aimaretti,M R Ambrosio,N Jia,A Giampietro,D Ferone,S Cannavo,M Poggi,C Di Somma,M Losa,P Beck-Peccoz

doi:10.1007/s40618-018-0860-x

Abstract

PurposeTo examine differences in effects according to growth hormone (GH) treatment duration in adult GH-deficient patients.MethodsIn the Italian cohort of the observational Hypopituitary Control and Complications Study, GH-treated adults with GH deficiency (GHD) were grouped by duration of treatment; ≤ 2 years (n = 451), > 2 to ≤ 6 years (n = 387) and > 6 years (n = 395). Between-group differences in demographics, medical history, physical characteristics, insulin-like growth factor-I standard deviation score (IGF-I SDS) and lipid profile at baseline, last study visit and changes from baseline to last study visit were assessed overall, for adult- and childhood-onset GHD and by gender using ANOVA for continuous variables and Chi-squared test for categorical variables.ResultsAt baseline, treatment duration groups did not differ significantly for age, gender, body mass index, GHD onset, IGF-I SDS, lipid profile, and quality of life. Mean initial GH dose did not differ significantly according to treatment duration group in any subgroup, except female patients, with highest mean dose seen in the longest duration group. In the longest duration group for patients overall, adult-onset patients and male patients, there were significant decreases in GH dose from baseline to last visit, and in total and low-density lipoprotein (LDL)-cholesterol concentrations. IGF-I SDS increased, to a greater extent, in the longest duration group for patients overall and female patients.ConclusionsThe results show that long-term GH treatment is associated with decreasing GH dose, increased IGF-I, decreased LDL-cholesterol and the presence of surrogate markers that help to give confidence in a diagnosis of GHD.

Highlights

Growth hormone (GH) deficiency in adult patients is associated with increased risk of mortality, predominantly due to cardiovascular disease [1,2,3,4]
In the observational Hypopituitary Control and Complications Study (HypoCCS) programme, data have been collected for a large number of adult patients with GH deficiency who were treated with GH [10, 11]
There was a significant difference between the groups in the type of stimulation test used for diagnosis of GH deficiency (Table 2)

Summary

Introduction

Growth hormone (GH) deficiency in adult patients is associated with increased risk of mortality, predominantly due to cardiovascular disease [1,2,3,4]. Adult patients diagnosed as having GH deficiency require continuous treatment with GH throughout their lives to maintain the metabolic benefits. Only limited data have been published that enable comparison of metabolic and hormonal effects between short-term versus long-term GH treatment [8, 9]. In the observational Hypopituitary Control and Complications Study (HypoCCS) programme, data have been collected for a large number of adult patients with GH deficiency who were treated with GH [10, 11]. The present analysis used the Italian cohort of patients in HypoCCS, which included data from patients with various durations of GH treatment. The present analysis was carried out to examine differences in baseline characteristics, efficacy and quality of life between patients who received GH treatment for different durations, to investigate changes in effects during short-term versus long-term treatment

Methods

Results

Conclusion