Growth Hormone Deficiency Management and Treatment

Growth Hormone Deficiency (GHD) is characterised by inadequate secretion of growth hormone, a peptide hormone pivotal to somatic growth and metabolic regulation. Management begins with careful clinical and biochemical assessment to confirm diagnosis, followed by individualised replacement therapy aimed at restoring normal physiology. In children, treatment seeks to normalise linear growth, optimise body composition and attain target height, while in adults it focuses on improving lean mass, reducing visceral adiposity and enhancing quality of life. Standard therapy involves daily subcutaneous injections of recombinant human GH, with dose titration guided by serum IGF-I levels, clinical response and tolerability. Over the past decade, long-acting GH analogues have been introduced to reduce injection frequency and improve adherence without compromising efficacy. Safety surveillance spanning decades has established an overall favourable benefit–risk profile, although ongoing monitoring of glucose metabolism and potential neoplastic risks remains essential. Emerging formulations, including PEGylated and albumin-binding derivatives, are expanding therapeutic choices and informing best-practice guidelines that balance efficacy, convenience and long-term safety.

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Growth Hormone Deficiency Management and Treatment publication trend

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Technical terms

Growth Hormone Deficiency (GHD): A clinical state marked by insufficient endogenous secretion of growth hormone, leading to impaired growth in children and metabolic dysregulation in adults.

Growth Hormone (GH): A peptide hormone secreted by the anterior pituitary gland that stimulates linear growth, protein synthesis and anabolic metabolism.

Long-Acting Growth Hormone (LAGH): Modified GH formulations designed to extend circulation time, allowing reduced injection frequency compared with daily GH therapy.

Insulin-Like Growth Factor I (IGF-I): A mediator of GH action, produced mainly in the liver, which promotes cell growth and differentiation and serves as a biomarker for GH treatment efficacy.

Height Velocity (HV): The rate of increase in stature over a specified time, typically expressed in centimetres per year and used to assess growth response to therapy.

Standard Deviation Score (SDS): A statistical measure indicating how many standard deviations a value lies above or below the age- and sex-matched population mean, used to standardise GH and IGF-I levels.

References

1. Comparing treatment with daily and long-acting growth hormone formulations in adults with growth hormone deficiency: Challenging issues, benefits, and risks. Best Practice & Research Clinical Endocrinology & Metabolism (2023).
2. Somapacitan in children born small for gestational age: a multi-centre, open-label, controlled phase 2 study. European Journal of Endocrinology (2023).
3. Growth Hormone Research Society perspective on the development of long-acting growth hormone preparations. European Journal of Endocrinology (2016).
4. GH safety workshop position paper: a critical appraisal of recombinant human GH therapy in children and adults. European Journal of Endocrinology (2015).
5. Usefulness and Potential Pitfalls of Long-Acting Growth Hormone Analogs. Frontiers in Endocrinology (2021).