Hernberg-Ståhl E, Luger A, Abs R, Bengtsson B A, Feldt-Rasmussen U, Wilton P, Westberg B, Monson J P
KIGS/KIMS Outcomes Research, Pharmacia AB, S-11287 Stockholm, Sweden.
J Clin Endocrinol Metab. 2001 Nov;86(11):5277-81. doi: 10.1210/jcem.86.11.7997.
The morbidity associated with GH deficiency (GHD) in adults is now well established. Furthermore, many controlled clinical trials have demonstrated the efficacy of GH replacement therapy. The aim of the present study was to determine whether the effects of GH replacement in adults are reflected in a reduced use of healthcare resources, in addition to improving quality of life (QoL). Data concerning visits to the doctor, number of days in hospital, and amount of sick leave were obtained from patients included in KIMS (Pharmacia International Metabolic Database), a large pharmacoepidemiological survey of hypopituitary adults with GHD, for 6 months before GH treatment and for 6-12 months after the start of treatment. Assistance required with normal daily activities was recorded at baseline and after 12 months of GH therapy. QoL (assessed using a disease-specific questionnaire, QoL-Assessment of GHD in Adults) and satisfaction with physical activity during leisure time were also assessed. For the total group (n = 304), visits to the doctor, number of days in hospital, and amount of sick leave decreased significantly (P < 0.05) after 12 months of GH therapy. Patients also needed less assistance with daily activities, although this was significant (P < 0.01) only for the men. QoL improved after 12 months of GH treatment (P < 0.001), and both the amount of physical activity and the patients' satisfaction with their level of physical activity improved after 12 months (P < 0.001). In conclusion, GH replacement therapy, in previously untreated adults with GHD, produces significant decreases in the use of healthcare resources, which are correlated with improvements in QoL.
成人生长激素缺乏症（GHD）的发病率现已明确。此外，许多对照临床试验已证明生长激素替代疗法的疗效。本研究的目的是确定成人生长激素替代疗法的效果除了改善生活质量（QoL）外，是否还体现在医疗资源使用的减少上。有关就诊次数、住院天数和病假天数的数据来自KIMS（法玛西亚国际代谢数据库）纳入的患者，这是一项针对患有GHD的垂体功能减退成人的大型药物流行病学调查，涵盖生长激素治疗前6个月以及治疗开始后6至12个月的数据。在基线时以及生长激素治疗12个月后记录正常日常活动所需的帮助。还评估了生活质量（使用特定疾病问卷《成人GHD生活质量评估》进行评估）以及休闲时间身体活动的满意度。对于整个组（n = 304），生长激素治疗12个月后，就诊次数、住院天数和病假天数均显著减少（P < 0.05）。患者在日常活动中所需的帮助也减少了，不过仅男性患者的这一变化具有显著性（P < 0.01）。生长激素治疗12个月后生活质量得到改善（P < 0.001），12个月后身体活动量以及患者对其身体活动水平的满意度均有所提高（P < 0.001）。总之，对于先前未接受治疗的患有GHD的成人，生长激素替代疗法可显著减少医疗资源的使用，且这与生活质量的改善相关。
