Endocrine Abstracts

Introduction: According to NICE: adults receiving growth hormone (GH) treatment, IGF1 levels should reach therapeutic range by 9 months. Patients are reviewed at 1, 3, 6, 9, 12 months and 6 months thereafter in our clinics. GH dose is titrated by 0.1 mg each visit. This work aims to compare the time it takes to get the IGF1 in range, between adults and adolescent patients attending our specialist regional clinics.

Method: We performed a retrospective audit of 20 patients with GH deficiency. (ten attended Transitional clinic: men=6, age 18–26 years, and ten attended the Adult GH clinic: men=10, age 41–75 years. Data was gathered using patient case notes and hospital systems.

Results: Of the ten adolescent patients, 20% achieved the therapeutic IGF1 range within nine months (10% at 3 months and 10% at 9 months). 80% achieved IGF1 target outside the 9 month period (10% at 12 months, 10% at 15 months, 30% at 21 months, 30% are still yet to reach their therapeutic range).

Of the ten adult patients, 70% achieved therapeutic IGF1 target within 9 months (20% at 1 month, 10% at 3 months, 30% at 6 months and 10% at 9 months). 30% achieved therapeutic IGF1 levels outside the 9 month period (10% at 12 months and 20% at 18 months).

The mean maintenance dose of GH for the adolescent patients was 0.6 mg and for the adult patients 0.2 mg.

Conclusion: Our results suggest adolescents do not reach therapeutic IGF1 as quickly as adults using GH replacement, most likely due to the higher GH dose requirements, which takes longer to achieve at 0.1 mg increments at 3 month follow up intervals. We suggest either increasing the follow up frequency or GH dose increments of 0.2 mg at current follow up interval.