Key result
Low-dose GH therapy optimizes IGF1 levels and reduces side effects compared to weight-based regimens.
Why the study?
Does low-dose individualized recombinant human GH therapy optimize IGF1 levels and reduce side effects in adult patients with GH deficiency?
Does low-dose individualized recombinant human GH therapy optimize IGF1 levels and reduce side effects in adult patients with GH deficiency?
This review supports current guidelines recommending low starting doses of GH (~1-4 mg/week) with individualized titration for adults with GH deficiency to avoid supraphysiological IGF1 levels and side effects.
Supports low-dose GH titration in adult deficiency to minimize side effects; confirms guidelines yet leaves open need for prospective RCTs.
Recombinant human GH has been licensed for use in adult patients with GH deficiency (GHD) for over 15 years. Early weight- and surface area-based dosing regimens were effective but resulted in supraphysiological levels of IGF1 and increased incidence of side effects. Current practice has moved towards individualised regimens, starting with low GH doses and gradually titrating the dose according to the level of serum IGF1 to achieve an optimal dose. Here we present the evidence supporting the dosing recommendations of current guidelines and consider factors affecting dose responsiveness and parameters of treatment response. The published data discussed here lend support for the use of low GH dosing regimens in adult GHD. The range of doses defined as 'low dose' in the studies discussed here (∼1-4 mg/week) is in accordance with those recommended in current guidelines and encompasses the dose range recommended by product labels.
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Gasco et al. (2012) conducted a review in Adult GH deficiency (GHD). Recombinant human GH was evaluated. Published data support the use of low GH dosing regimens (~1-4 mg/week) in adult GH deficiency, aligning with current guidelines and product labels.
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