Long-Acting Weekly Versus Daily Growth Hormone Therapy For Adult Patients

A study published in Diabetes & Metabolic Syndrome stated that no meta-analysis has assessed long-acting growth hormone (GH) therapy in adult patients with GH deficiency. Thus, researchers, led by Deep Dutta, conducted a meta-analysis on weekly long-acting GH regimens, as compared to daily GH and placebo controls, and found that long-acting GH had a “comparable beneficial impact on body composition parameters in adult GH deficiency, [and] is well tolerated without any increased adverse events.” 

The analysis included a total of 648 patients from five randomized clinical trials (RCTs), four with daily GH active controls and one with placebo controls. The primary outcome of the analysis was the changes in body-composition parameters in patients. Additional outcomes included evaluating alterations in glycaemia and adverse events.

According to the report, over 24 to 34 weeks of clinical treatment, the patients who received long-acting GH had changes in lean mass (mean deviation [MD] –0.28 kg; 95% confidence interval [CI], 0.94–0.38; p = 0.41; I² = 29%], and fat mass (MD –0.10 kg; 95% CI, 1.97–1.78; p = 0.92; I² = 77%) that were comparable to those from daily GH injections. Compared to daily GH, long-acting GH use was also associated with significantly lower visceral adipose tissue (MD –1.75 cm²; 95% CI, 2.14 to –1.35; p <0.01; I² = 0%) and higher gynoid fat-mass (MD 0.14 kg; 95% CI, 0.02–0.26; p = 0.03).

Regarding safety, the rate of total adverse events (risk ratio [RR] 1.65; 95% CI, 0.83–3.29); p = 0.15; I² = 68%), and severe adverse events (RR 0.60; 95% CI, 0.30–1.19; p = 0.14; I² = 0%) were not significantly different between long-acting GH and control groups. Notably, long-acting GH patients showed significantly higher treatment adherence compared to controls (95% CI, 3.58–6.02; p <0.01: I² = 0%).

Given the comparable safety profiles and potential advantages of long-acting GH regimens for adult patients with GH deficiency, Dutta and colleagues reported an overall favorable recommendation for long-acting GH as compared to daily GH injectables.