Short-term efficacy of recombinant human GH therapy in cured acromegaly patients with GH deficiency: a single-center experience

Abstract

The effectiveness and short-term safety of recombinant human GH (r-hGH) in acromegaly patients with GH deficiency (GHD) after treatment are not well established. The study includes ten subjects with acromegaly who had GHD treated with r-hGH for 6 months. Control groups consisted of ten age-, gender-, and BMI-matched healthy subjects and ten active acromegaly patients who were treatment naïve. Body composition, quality of life (QoL), muscle strength, lipid profile, and cardiovascular risk factors were assessed in all subjects at baseline, and the same parameters were reassessed after 6 months of therapy with r-hGH in acromegaly with GHD. Repeat magnetic resonance imaging of the sella was performed in treated subjects. Optical colonoscopy was done and biopsies were taken from multiple sites for proliferation indices (Ki67). The median duration of GHD was 17.8 months and dose of r-hGH administered was 5.7±1.5 μg/kg per day. There was improvement in bone mineral content (P=0.01), bone mineral density (P=0.04), muscle strength (P<0.001), total cholesterol (P=0.003), high-density cholesterol (P<0.001), and QoL – score (P=0.005), and reduction in low-density cholesterol (P=0.003) and triglyceride (P=0.004) after treatment. There was no change in lean body mass, total body fat, hsCRP, lipoprotein (a), and fibrinogen levels. There was a modest increase in plasminogen activator inhibitor 1 (P=0.002), but it was lower compared with healthy controls and treatment naïve acromegalics (P=0.007). Six month-r-hGH therapy improves body composition, atherogenic lipid profile, QoL, and muscle strength in GHD patients who had acromegaly. Long-term prospective studies are needed to evaluate the effect of r-hGH therapy in these patients.

Co-Occurrence of Acromegaly and Hematological Disorders: A Myth or Common Pathogenic Mechanism

“…The coagulopathy is due to thrombin activation. Our previous results have demonstrated that acromegaly patients with GHD who were treated with recombinant GH showed increase activity of plasminogen activator inhibitor-1; however, our study was too short to examine the risk of leukemia [16] .…”

Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?

“…Copyright © 2020 Korean Endocrine Society shown to improve IGF-1 concentrations and quality of life without deleterious adverse effects [72,73]. Tritos et al [74], however, warned of increased cardiovascular complications in GH replacement and recommended further investigation on whether it was due to previous GH excess in acromegaly.…”

“…Ku et al [ 71 ] found that the presence of a bilateral pituitary tumor and low immediate post-operative 72-hour GH concentrations (below 0.23 mg/L) predicted GHD. Administration of recombinant GH has been shown to improve IGF-1 concentrations and quality of life without deleterious adverse effects [ 72 , 73 ]. Tritos et al [ 74 ], however, warned of increased cardiovascular complications in GH replacement and recommended further investigation on whether it was due to previous GH excess in acromegaly.…”