ECE2011 Poster Presentations Pituitary (111 abstracts)
Leiden University Medical Center, Leiden, The Netherlands.
Context: Recombinant human GH (rhGH) is indicated for the treatment of adult subjects with GH deficiency (GHD). However, conflicting data are available on the efficacy of rhGH treatment in elderly GHD patients.
Objective: To assess the efficacy of rhGH treatment in elderly GHD subjects.
Methods: We searched PubMed, Cochrane Library, Web of Science, and EMBASE.
Study selection: Eligible studies included GHD patients, aged >60 years, treated by rhGH. Data extraction was performed by two reviewers independently.
Results: We found 11 eligible studies with a total of 534 patients. Only 2 studies had prospective, randomized, placebo-controlled study designs with a duration of rhGH treatment of 6 (n=15) and 12 months (n=62), respectively. Treatment with rhGH decreased total and LDL-cholesterol levels by 48 and 1116%, respectively, but did not alter HDL or triglyceride (TG) levels. RhGH did not affect body mass index, but decreased waist circumference (by~3 cm) and waist/hip ratio. RhGh did not consistently affect blood pressure or bone mineral density. RhGH increased lean body mass by 25% and decreased total fat mass by 710% in 4 studies, but did not affect body composition in 2 other studies. RhGH consistently improved quality of life parameters reflected in AGHDA-scores. There are no explicit data on elderly GHD patients aged >80 years.
Conclusion: The effects of rhGH replacement in elderly subjects with GHD are relatively limited. In addition, there are no data on the efficacy and safety of rhGH treatment in GHD octogenarians.