Endocrine Abstracts

Introduction: In the UK, most adult patients with growth hormone deficiency (GHD) continue with growth hormone (GH) treatment indefinitely, even when they do not report any benefits from treatment. To date, the optimal duration of GH treatment in adults has not been established. We conducted a survey of UK endocrine clinicians between 01/06/2022 and 31/08/2022 to understand current practices regarding GH treatment discontinuation in adults with GHD.

Methods: Using an online platform Survey Monkey®, a web-based multiple-choice questionnaire was sent to the UK Society for Endocrinology membership. It consisted of 15 questions on demographics, number of patients receiving GH treatment and their current practice related to GH treatment discontinuation.

Results: 102 endocrine clinicians completed the survey with majority from England (n=91, 89%). 65 respondents (33 endocrinologists and 32 specialist nurses) indicated active involvement in managing adult patients with GHD. 27.7% of the 65 clinicians (n=18) were routinely offering GH treatment discontinuation to adults receiving long-term GH therapy. Only 6% (n=4) used a clinical guideline/protocol to direct their practice of GH treatment discontinuation. 29.2% (n=19) supported that GH treatment discontinuation should be routinely offered to patients on long-term treatment with a further 60% (n=39) would consider treatment discontinuation for long-term users, whilst 9.2% (n=6) indicated that discontinuation should not be offered. During the period of GH treatment discontinuation, most clinicians monitor signs and symptoms (75.4%, n=49), measure IGF-1 levels (84.6%, n=55) and complete a quality of life assessment (89.2%, n=58).

Conclusions: This survey demonstrates that a significant number of clinicians would consider GH treatment discontinuation in adult patients with GHD who have been on long-term treatment. In the absence of clear evidence on the effects of GH treatment discontinuation in adults, more research is needed to guide the development of evidence-based recommendations that will inform clinical practice.