ICEECE2012 Poster Presentations Pituitary Clinical (183 abstracts)
Mortality rates in childhood and adult onset GH deficient patients enrolled in the Global Hypopituitary Control and Complications Study (HypoCCS)
H. Jung 1 , A. Zimmermann 2 , D. Mo 2 , L. Robison 3 , E. Erfurth 4 , S. Melmed 5 , S. Lamberts 6 & A. Attanasio 7
1Eli Lilly and Company, Bad Homburg, Germany; 2Eli Lilly and Company, Indianapolis, Indina, USA; 3St. Jude Children’s Research Hospital, Memphis, TN; 4SUS, Lund University, Lund, Sweden; 5Cedars-Sinai Medical Center, Los Angeles, California, USA; 6Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; 7Cascina del Rosone, Agliano Terme, Italy.
Preliminary data suggested an increased mortality in a French cohort after childhood somatropin treatment compared to the French reference population1. This cohort included patients (pts) with idiopathic-isolated GH-deficiency (GHD), and a similar cohort is also under follow-up for adult GH-replacement in HypoCCS.
We therefore assessed all-cause mortality rates (n/1000 person-years (PY), (95% CI), standardized to the age/gender structure of HypoCCS or the general population) in 7946 GH-replaced adult HypoCCS pts with available post-baseline information. Overall standardized (general population) mortality rate was 5.8 (4.3, 7.2) in the US HypoCCS cohort compared to 7.6/1000 PY in the US general population2, and 5.2 (4.4, 6.1) in Europe, the rate in comparable populations ranging from 5.1/1000 PY in Italy to 6.4/1000 PY in Belgium3. As shown in the table, mortality rates were not different between onset-types overall and for non-idiopathic GHD, but were lower in childhood onset (CO) compared to adult onset (AO) pts with idiopathic GHD replaced with GH.
Of a total of 174 deaths, 14 occurred in CO pts and only in the non-idiopathic GHD group (acute illness/suicide (7), second/recurrent neoplasm (2), cerebral hemorrhage/carotid artery stenosis (2) or unknown reason (3)).
Although the Carel et al. study1 raises the important question of increased adult mortality after somatropin treatment in childhood, the present analysis does not confirm an increased mortality in GH-replaced adult pts, either with CO or AO GHD, compared to reference populations. However, the present results are limited by selection bias and relatively short follow-up time.
1. J-C et al., Endocr Rev 2011, 32 LB-5.
2. Xu J et al., National Center for Health Statistics; 2010. May 20, 58(19).
3. World Health Organisation Mortality Statistics. http://data.euro.who.int/dmdb/Help/inds.htm. Accessed: 22 March 2011.
Declaration of interest: I fully declare a conflict of interest. Details below:
Funding: This work was supported, however funding details unavailable.
| Onset-type | All (n=7946) | IdiopathicGHD (n=1267) | Idiopathic-isolated GHDa (n=530) | Non-idiopathicGHD (n=6679) |
| CO (n=1528) | 3.2(0.2,6.2) | 0 | 0 | 5.4 (0.2,10.6) |
| AO (n=6418) | 5.4 (4.5,6.3) | 7.0 (3.9,10.1) | 3.7 (0,7.8) | 5.3 (4.3,6.2) |
| aSub-group of idiopathic GHD. | ||||
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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