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EndoERN, APHP Consortium Pitie Salpetriere Hospital, Necker Hospital, Paris, France
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EndoERN, APHP Consortium Pitie Salpetriere Hospital, Necker Hospital, Paris, France
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EndoERN, APHP Consortium Pitie Salpetriere Hospital, Necker Hospital, Paris, France
Sorbonne University, Paris, France
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Höybye C Carroll P Gordon MB Birkegård AC Kelepouris N Nedjatian N Weber MM . Pregnancy outcomes in women receiving growth hormone replacement therapy enrolled in the NordiNet® International Outcome Study (IOS) and the American Norditropin
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Introduction:
Adult-onset growth hormone deficiency (AGHD) is usually the last deficiency to be substituted in hypopituitarism. In children with documented GH deficiency, treatment without delay is crucial for achieving optimal effects on growth and development. In adults, it is not known whether a delay in treatment initiation influences biochemical response and the favourable physiological effects resulting from GH replacement therapy (GHRT).
Methods:
A total of 1085 GH-deficient adults from KIMS (Pfizer International Metabolic Database) were included, adequately replaced with all pituitary hormones except for GH at baseline. Patients were stratified by sex and age (20–50 years and ≥50 years) and subsequently divided into two groups below and above the median duration of unsubstituted AGHD for that subgroup. The median time of unsubstituted GHD for the total cohort was 2.53 years (P5 = 0.35, P95 = 24.42).
Results:
Beneficial effects of 4 years of GHRT were observed on lipids and quality of life in all subgroups. A decrease in waist circumference was observed only in older (>50 years) patients. There was no difference in IGF-I SDS and in GH dose required to normalize IGF-I in patients with a duration of unsubstituted AGHD above or below the median. No relevant differences were found between the groups for anthropometric measures, cardiovascular risk factors and quality of life scores.
Conclusion:
In contrast to GHD in children and adolescents, no difference could be established in treatment response between early or late initiation of GHRT in AGHD in terms of required GH dose, IGF-I, metabolic health and quality of life.
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ML . Efficacy and tolerability of an individualized dosing regimen for adult growth hormone replacement therapy in comparison with fixed body weight-based dosing . Journal of Clinical Endocrinology and Metabolism 2004 89 3224 – 3233 . ( doi:10
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local shared care agreement • Has knowledge and understanding of appropriate investigations required a • Knows contraindications for growth hormone replacement therapy • In accordance with NICE guidelines, is able to initiate and adjust growth
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.85.7.6699 ). 4 Van Bunderen CC van Varsseveld NC Heymans MW Franken AA Koppeschaar HP Van der Lely AJ Drent M . Effect of long-term growth hormone replacement therapy on cardiovascular outcomes in growth hormone deficient patients
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cardiovascular morbidity in hypopituitary adults with or without growth hormone replacement therapy . Journal of Clinical Endocrinology and Metabolism 2004 89 3306 – 3312 . ( https://doi.org/10.1210/jc.2003-031601 ) 20 Bulow B Hagmar L Mikoczy Z
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Van Bunderen CC van Nieuwpoort IC Arwert LI Heymans MW Franken AA Koppeschaar HP van der Lely AJ Drent ML 2011 Does growth hormone replacement therapy reduce mortality in adults with growth hormone deficiency? Data from the Dutch
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Metabolism 2003 284 E1149 – E1155 . ( https://doi.org/10.1152/ajpendo.00410.2002 ) 10.1152/ajpendo.00410.2002) 23 de Boer H Blok GJ Popp-Snijders C Stuurman L Baxter RC van der Veen E . Monitoring of growth hormone replacement therapy in adults
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Department of Medicine, Karlstad Hospital, Karlstad, Sweden
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) 27736009 13 Jørgensen AP Fougner KJ Ueland T Gudmundsen O Burman P Schreiner T Bollerslev J . Favorable long-term effects of growth hormone replacement therapy on quality of life, bone metabolism, body composition and lipid levels in patients with adult
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