Department of Endocrinology and Department of Molecular Medicine and Surgery, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
Best Pract Res Clin Endocrinol Metab. 2023 Dec;37(6):101788. doi: 10.1016/j.beem.2023.101788. Epub 2023 Jun 5.
Daily administration of growth hormone (GH) treatment has been in clinical use for treatment for GH deficiency (GHD) in adults for more than 30 years. Numerous studies have demonstrated evidence that GH treatment improves body composition, cardiovascular risk factors and quality of life with few side effects. Less frequent GH injections are hypothesized to improve adherence and several long-acting GH (LAGH) formulations have been developed and a few have been approved and marketed. Different pharmacological modifications have been applied and the pharmacokinetics and pharmacodynamics of LAGH are different to each other and to those of daily injections and require different dosing and monitoring specific for each LAGH. Studies have shown improved adherence with LAGH, and short-term efficacy and side effects are comparable between daily GH injections and LAGHs. Long-term treatment with daily GH injections is effective and safe, while long-term studies for LAGHs are awaited. In this review challenges, benefits, and risks of treatment with daily and long-acting GH preparations will be compared.
每日给予生长激素（GH）治疗已在临床上用于治疗成人 GH 缺乏症（GHD）超过 30 年。大量研究证明，GH 治疗可改善身体成分、心血管危险因素和生活质量，且副作用较少。较少频率的 GH 注射被假设可提高依从性，因此已开发出几种长效 GH（LAGH）制剂，其中一些已获得批准并上市。已经应用了不同的药理学修饰，LAGH 的药代动力学和药效动力学彼此不同，并且与每日注射的药代动力学和药效动力学不同，因此需要针对每种 LAGH 进行特定的剂量调整和监测。研究表明，LAGH 治疗的依从性得到改善，短期疗效和副作用在每日 GH 注射和 LAGHs 之间是可比的。每日 GH 注射的长期治疗是有效的且安全的，而 LAGH 的长期研究尚待进行。在本综述中，将比较每日和长效 GH 制剂治疗的挑战、益处和风险。
