Endocrine Abstracts

Introduction: In 2003, the UK National Institute for Clinical Excellence (NICE) established guidelines on the use of GH in adults. These guidelines state that recombinant GH should be used only for adults with a severe GH deficiency that severely affects their quality of life. To assess current practice in relation to these guidelines, a review of patients receiving GH treatment was performed. The aims were to assess if adults with GH deficiency met NICE criteria for GH therapy and to identify reasons for initiating or continuing GH treatment if NICE criteria were not met.

Methods: Retrospective case note review of adults and young adults in transition receiving growth hormone therapy at the Royal Derby Hospital up to May 2016.

Results: Thirteen patients (ten males and three females) included in this study, two were excluded (one male and one female). Two patients had previous pituitary surgery. Six patients had Multiple Pituitary Hormones Deficiency (MPHD). All thirteen patients were assessed as adults requiring GH replacement. All patients fulfilled all criteria for commencing GH therapy. the diagnosis was secured with Insulin Stimulation test (ITT) in 8 patients (61.5%) and with Glucagon Stimulation test (GST) in the rest. 6 (46.15%) patients were treated with Surepal, 5 (38.46%) with Saizen, 1 (7.28%) with Genotropin and 1 (7.28%) with Humatrop respectively. 13 (100%) of patients were assessed with QOL-AGHDA questionnaire at baseline and all were reassessed within 12 months and met criteria to continue. There were no records of any initiation of treatment for childhood GH deficiency in this study.

Conclusion: All patients meet the NICE criteria for GH replacement therapy. The QOL-AGHDA questionnaire may have limitations given the subjective nature of questionnaires and comorbidities influencing quality of life. Additionally, consideration of both clinical evidence and patients’ wishes may prove to be beneficial when commencing and reassessing patients on GH treatment.