Which adults develop side-effects of growth hormone replacement?

Area of Science:

• Endocrinology
• Metabolic Disorders
• Pharmacology

Background:

• Side effects of growth hormone (GH) replacement in adults are known but poorly understood.
• Identifying predictors of GH replacement side effects is crucial for optimizing treatment.
• GH deficiency in adults can stem from childhood or adult-onset conditions.

Purpose of the Study:

• To identify patient characteristics predicting the development of side effects during GH replacement therapy in adults.
• To compare adults with GH deficiency based on the occurrence and severity of side effects.

Main Methods:

• A 12-month study involving 63 adults with GH deficiency.
• GH replacement therapy administered over 12 months (6 months double-blind placebo-controlled, 6 months open-label).
• Comparison of patient demographics, GH deficiency characteristics, and IGF-I levels between groups experiencing different side effect profiles.

Main Results:

• Patients requiring GH dose reduction due to side effects were older, heavier, had higher BMI, and a greater peak serum GH response.
• Adult-onset GH deficiency was associated with a higher likelihood of experiencing side effects requiring dose reduction.
• Patients with side effects not requiring dose reduction showed a greater increment in IGF-I standard deviation score (SDS) after 6 months.

Conclusions:

• Older age, higher weight and BMI, adult-onset GH deficiency, and higher peak GH response predict GH replacement side effects.
• A greater increase in IGF-I SDS during therapy is linked to developing side effects not necessitating dose reduction.
• These factors can help anticipate and manage side effects in adults undergoing GH replacement.