Department of Internal Medicine, Endocrine Division (SEMPR), University Hospital, Federal University of Parana, Curitiba, Brazil.
Best Pract Res Clin Endocrinol Metab. 2023 Dec;37(6):101817. doi: 10.1016/j.beem.2023.101817. Epub 2023 Aug 24.
Daily injections of recombinant human growth hormone (rhGH) have been used in clinical practice for almost four decades as a replacement therapy in adult patients with GH deficiency (GHD). Long-term adherence to daily injections of rhGH is a clinical concern that may result in reduced therapeutic efficacy, and long-acting GH (LAGH) formulations have been developed in an attempt of overcoming this problem. Long-term safety issues of rhGH are the other side of the coin that has been carefully monitored over the years, particularly related to the proliferative actions of GH that could increase the risk of tumor recurrence or induce the development of new benign and malignant tumors. In this review, we present what is currently known about the cancer risk in GHD adults treated with daily rhGH injections and we discuss the major concerns and responses needed from future surveillance studies regarding the safety of LAGH preparations.
每日注射重组人生长激素(rhGH)在临床实践中已应用近四十年,作为成人生长激素缺乏症(GHD)患者的替代疗法。长期坚持每日注射 rhGH 是一个临床关注的问题,可能导致治疗效果降低,因此长效 GH(LAGH)制剂已经被开发出来,试图克服这个问题。rhGH 的长期安全性问题是另一个需要仔细监测的问题,特别是与 GH 的增殖作用有关,这可能会增加肿瘤复发的风险或诱导新的良性和恶性肿瘤的发展。在这篇综述中,我们介绍了目前已知的接受每日 rhGH 注射治疗的 GHD 成年人的癌症风险,并讨论了未来监测研究中需要关注的主要问题和应对措施,以确保 LAGH 制剂的安全性。