New Treatments for Growth Hormone Deficiency

First recognized in the early 20th century, growth hormone deficiency (GHD) has been treated with growth hormone (GH) replacement since 1958. Initial replacement was with cadarevic GH. In 1985, GH therapy with recombinant human GH (rhGH) replaced cadaveric GH, which increased not only safety, but also efficacy (because of increased supply). Improvements in GH dosing and frequency of injection has resulted in adult heights now usually in the normal range. GHD is diagnosed from the clinical picture, along with measurement of serum insulin-like growth factor 1 (IGF-I), IGF binding protein-3, and GH response to provocative stimuli. Several long-acting GH preparations are now under development. There has been a great deal of data from databases that confirms safety of GH administration while patients are taking GH. A recent report of increased mortality risk in adults who were treated with GH as children has not been confirmed by a second similar retrospective evaluation. Additional long-term follow-up studies of adults who took GH as children are needed.