Efficacy and safety of long-acting growth hormone in adult growth hormone deficiency: A systematic review and meta-analysis

Background & aims: No meta-analysis has analysed efficacy and safety of long-acting growth hormone (GH) therapy in adult GH deficiency. We undertook this meta-analysis to address this gap in knowledge Methods: Electronic databases were searched for RCTs involving adult GH deficiency patients receiving weekly long-acting GH as compared to daily GH/placebo controls. Primary outcome was to evaluate changes in body-composition parameters. Secondary outcomes were to evaluate alterations in glycaemia and adverse-events. Results: Data from 5 studies involving 648 patients were analysed (4 studies having daily GH as active controls; 1 study having placebo as passive controls). Over 24-34 weeks clinical use, patients receiving long-acting GH had comparable change in lean mass [MD-0.28 kg (95%CI: 0.94 - 0.38); P = 0.41; I-2 = 29% (low heterogeneity)] and fat mass [MD-0.10 kg (95%CI: 1.97-1.78); P = 0.92; I-2 = 77%(considerable heterogeneity)] as compared to daily GH injections. Long-acting GH use was associated with significantly lower visceral adipose tissue [MD-1.75 cm(2)(95%CI: 2.14 to -1.35); P < 0.01; I-2 = 0% (low heterogeneity)] and higher gynoid fat-mass [MD 0.14 kg(95%CI:0.02-0.26); P = 0.03] compared to daily GH injections. Total adverse events [Risk ratio (RR) 1.65 (95% CI: 0.83-3.29); P = 0.15; I-2 = 68%] and severe adverse events [RR 0.60 (95% CI: 0.30-1.19); P = 0.14; I-2 = 0%] were not significantly different in long-acting GH group compared to controls. Occurrence of headache, arthralgia, nasopharyngitis, new onset diabetes, anti-GH antibodies were comparable among groups. Long-acting GH users had significantly higher treatment adherence compared to controls [OR 4.80 (95%CI:3.58-6.02); P < 0.01; I-2 = 0%]. Conclusion: Long-acting GH has comparable beneficial impact on body composition parameters in adult GH deficiency, is well tolerated without any increased adverse events. (C) 2022 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Automated summary

This meta-analysis showed that long-acting growth hormone therapy is effective and safe for adult growth hormone deficiency patients, with comparable improvements in body composition parameters and no increased adverse events.