Endocrine Abstracts

Background

Growth hormone replacement therapy in adults is mostly used in case of adult growth hormone deficiency (AGHD). The condition is characterized by altered body composition, lower than average bone mineral density (BMD), elevated cardiovascular risks and, among other remaining factors, lower quality of life.

Main discussion topics

After over 30 years of recombinant growth hormone (rGH) usage substantial data has been accumulated to assess treatment efficacy and safety. Careful consideration should be given to the question who is eligible for rGH treatment. Transition patients warrant extra attention to determine the correct dose at a given period of time and to avoid losing the patient out of site. Body composition and increase of BMD seem to be the most prominent benefits with an increase in exercise capacity and quality of life following suit. The effects on cardiovascular risks are less certain. The ultimate end-point criteria – weather rGH therapy in adults decreases mortality – also remains unclear. With a growing interest toward endocrinology for anti-aging therapy and biohacking, physicians need to continue discussion as to what is safe and what is off-limits in situations outside of pathology. Therapy monitoring is very important during treatment to detect possible side effects and to make sure that treatment yields the expected benefits. These aspects find new importance with the development of long-lasting GH forms. Despite available data, optimal safety and efficacy biomarkers still pose a challenge. Combining rGH with other hormones warrants extra attention.

Conclusion

rGH therapy has proven positive effects on patients with GH deficiency. Some benefits, as in reduction of cardiovascular risks, remain to be determined. Finding optimal biomarkers to monitor treatment safety and efficacy remain somewhat elusive. Ever-growing interest of healthy individuals for GH treatment warrants and endocrinologist’s attention.