Effect of growth hormone replacement therapy on the quality of life in women with growth hormone deficiency who have a history of acromegaly versus other disorders

• Published in: Endocrine practice Vol. 18; no. 2; p. 209
• Main Authors: Valassi, Elena, Brick, Danielle J, Johnson, Jessica C, Biller, Beverly M K, Klibanski, Anne, Miller, Karen K
• Format: Journal Article
• Language: English
• Published: United States 01-03-2012
• Subjects: Acromegaly - drug therapy; Acromegaly - physiopathology; Acromegaly - psychology; Adult; Aged; Body Mass Index; Double-Blind Method; Female; Hormone Replacement Therapy - adverse effects; Human Growth Hormone - adverse effects; Human Growth Hormone - deficiency; Human Growth Hormone - therapeutic use; Humans; Hypothalamic Diseases - drug therapy; Hypothalamic Diseases - physiopathology; Hypothalamic Diseases - psychology; Massachusetts; Middle Aged; Pituitary Diseases - drug therapy; Pituitary Diseases - physiopathology; Pituitary Diseases - psychology; Psychiatric Status Rating Scales; Quality of Life; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; Remission Induction; Single-Blind Method; Surveys and Questionnaires; Young Adult; Massachusetts
• ISSN: 1934-2403
• DOI: 10.4158/EP11134.OR

To compare the response in quality of life (QoL) to growth hormone (GH) replacement in women with GH deficiency (GHD) and a history of acromegaly with that in women with GHD of other causes.
Fifty-five women with GHD were studied: 17 with prior acromegaly and 38 with other causes of GHD. We compared two 6-month, randomized, placebo-controlled studies of GH therapy in women with hypopituitarism conducted with use of the same design-one in women with a history of acromegaly and one in women with no prior acromegaly. QoL was assessed with the following questionnaires: the QoL-Assessment of Growth Hormone Deficiency in Adults (AGHDA), the Symptom Questionnaire, and the 36-Item Short-Form Health Survey (SF-36).
The 2 groups had comparable mean pretreatment age, body mass index, and QoL scores and comparable mean GH dose at 6 months (0.61 ± 0.30 versus 0.67 ± 0.27 mg daily). After 6 months of GH replacement therapy, women with GHD and prior acromegaly demonstrated a greater improvement in AGHDA score, four SF-36 sub-scales (Role Limitations due to Physical Health, Energy or Fatigue, Emotional Well-Being, and Social Functioning), and the Somatic Symptoms subscale of the Symptom Questionnaire than did women with GHD of other causes. Poorer pretreatment QoL was associated with a greater improvement in QoL after administration of GH.
In this study, GH replacement therapy improved QoL in women with GHD and a history of acromegaly but not in women with GHD due to other hypothalamic and pituitary disorders. Further studies are needed to determine the long-term risks versus benefits of GH replacement in patients who develop GHD after definitive treatment for acromegaly.