Endocrine Abstracts

Introduction: Patients with AGHD receiving GH often have comorbidities requiring concomitant treatment. We evaluated patterns of concomitant medication use relative to GH therapy initiation in patients with AGHD.

Methods: Patients with AGHD with data on concomitant medications enrolled in NordiNet^® IOS (NCT00960128), an international, non-interventional study, receiving GH (Norditropin^®, Novo Nordisk A/S, Denmark) therapy were included. Concomitant medications were grouped by main therapeutic properties/target body system into nine treatment clusters. Start of concomitant medication in each cluster was analysed relative to GH therapy initiation (before/at[±2 months]/after). The association between concomitant medication start and GH initiation (after versus before) was analysed by chi-square test.

Results: Overall, 14,412 prescriptions of concomitant medications were recorded for 986 patients (female, 42%; adult-onset AGHD, 88%), representing 42% of all patients with AGHD in NordiNet^® IOS. The most frequent treatment clusters and numbers of patients (% patients with first prescription before/at/after GH initiation) receiving at least one treatment in each cluster were: hormone (other pituitary/sex hormones) replacement, 952 (60%/20%/20%); cardiovascular system therapies, 169 (43%/17%/41%); nutrition and supplements, 97 (28%/23%/49%); diabetes treatment, 61 (33%/25%/43%); osteoporosis treatment, 53 (32%/23%/45%); nervous system treatment, 44 (34%/30%/36%); pain relievers, 46 (52%/17%/30%); prolactin suppression therapy, 44 (50%/18%/32%); fertility treatment, 14 (57%/0%/43%); miscellaneous, 90 (41%/23%/36%). Except for hormone replacement therapy, and nutrition and supplements (P<0.05 for both), no significant differences were shown in the proportions of patients receiving their first concomitant medication prescription after versus before GH initiation within treatment clusters.

Conclusions: Hormone replacement and cardiovascular system treatments were the most frequently prescribed concomitant medications. There was no change in the proportion of first prescriptions for cardiovascular system, diabetes or osteoporosis treatments after versus before GH therapy initiation. The high proportion of prescriptions for other hormone replacement therapy before GH initiation indicates GH might often be the last pituitary hormone to be substituted.