Two years of replacement therapy in adults with growth hormone deficiency

Verhelst, Johan; Abs, Roger; Vandeweghe, Mark; Mockel, Jean; Legros, Jean-Jacques; Copinschi, Georges; Mahler, C.; Velkeniers, B.; Vanhaelst, L.; Aelst, A. Van; Rijdt, D. De; Stevenaert, Achille; Beckers, Albert

doi:10.1046/j.1365-2265.1997.3041112.x

Cited by 83 publications

(51 citation statements)

References 20 publications

(33 reference statements)

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“…Indeed, a placebo effect on QoL has been observed using the Symptom Checklist-90 (SCL-90), the Social Adjustment Scale (SAS) (Florkowski et al 1998), the NHP (Burman et al 1995, Verhelst et al 1997, and the PGWB (Carroll et al 1997). Double-blind, placebo-controlled protocols have been developed to overcome the placebo effect, but the overt physical changes resulting from GH therapy render a true 'double-blind' protocol virtually impossible (Mardh et al 1994).…”

Section: Placebo Effectmentioning

confidence: 99%

Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

Hull

Harvey²

2003

Journal of Endocrinology

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The actions of growth hormone (GH) are not restricted to growth: GH modulates metabolic pathways as well as neural, reproductive, immune, cardiovascular, and pulmonary physiology. The importance of GH in most physiological systems suggests that GH deficiency at any age would be associated with significant morbidity. However, prior to the advent of recombinant GH, cadaverderived GH was only used therapeutically to correct the height deficit, and thereby hypothetically improve quality of life (QoL), in GH-deficient children. Physicians now have access to unlimited, albeit expensive, supplies of recombinant GH, and are considering the advisability of GH replacement or supplementation in other patient populations. This paper analyses studies investigating the relationship between GH and QoL in GH-deficient children or adults, in GH-replete short children suffering from idiopathic short stature, Turner syndrome, or intrauterine growth retardation and in GH-deficient or replete elderly adults. Possible mechanisms by which GH might improve QoL at neural and somatic sites are also proposed.

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Section: Placebo Effectmentioning

confidence: 99%

Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

Hull

Harvey²

2003

Journal of Endocrinology

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“…In this regard, hypopituitary patients with untreated GHD have been shown to have a higher cost to society in terms of lost production and medical consumption [113]. Verhelst and colleagues observed a decreased number of sick days after replacement therapy, from 12 days at baseline to 7 days in 6 months of therapy and to 3 days in 24 months of therapy [114]. More recently, a specific study on this subject demonstrated that GH therapy is a cost-effective therapy in Sweden when considering morbidity and mortality associated with GHD and the impact on quality of life [115].…”

Section: Safety and Cost Effectiveness Of Long-term Use Of Gh Therapymentioning

confidence: 99%

Impact of adult growth hormone deficiency on metabolic profile and cardiovascular risk [Review]

et al. 2015

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Abstract. Adult growth hormone deficiency (GHD) is a well defined clinical condition, which is characterized by abnormal body composition, impaired physical activity and decreased quality of life. In addition, in recent years, growing interest has been shown towards cardiovascular risks in adult patients affected by GHD. In this regard, GHD is widely known to be associated with increased mortality, likely due to the increase of risk factors, such as central obesity, impaired lipid and glucose profiles and other less-known risk factors, such as inflammatory cytokines, endothelial dysfunction and oxidative stress. However, very few papers have recently discussed this topic. In this review, the aim is to clarify this issue by discussing evidence regarding the effects of adult GHD on metabolic and cardiovascular profiles.

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“…One randomized clinical trial showed a decrease in the number of hospitalization days and sick leave days in patients who received an active drug (18).…”

Section: Healthcare Utilizationmentioning

confidence: 99%

Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

Kołtowska-Häggström¹,

Mattsson²,

Shalet³

2009

European Journal of Endocrinology

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Quality of life (QoL) has emerged as an important construct that has found numerous applications across healthcare-related fields, ranging from research and clinical evaluation of treatment effects to pharmacoeconomic evaluations and global healthcare policy. Impairment of QoL is one of the key clinical characteristics in adult GHD and has been extensively studied in the Pfizer International Metabolic Database (KIMS). We provide summarized evidence on GH treatment effects for both clinical and health economic applications based on the KIMS data. The primary focus is on those aspects of QoL research that cannot be investigated in the traditional clinical trial setting, such as specific patient subgroups, cross-country comparisons and long-term follow-up. First, the impact of age, gender, disease onset, primary aetiology, extent of hypopituitarism, previous radiotherapy and obesity on QoL before and during long-term GH replacement is discussed. Secondly, the studies on QoL in relation to country-specific normative values are reviewed. Finally, health economic data derived from KIMS including both burden of disease and utility assessment are evaluated. We conclude that the wide spectrum of analyses performed on the KIMS data allows for practical application of the results not only to research and clinical practice but also to health policy and global medical decision making.

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Two years of replacement therapy in adults with growth hormone deficiency

Cited by 83 publications

References 20 publications

Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

Impact of adult growth hormone deficiency on metabolic profile and cardiovascular risk [Review]

Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

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