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儿童生长激素缺乏症的长效生长激素治疗:共识声明

Long-Acting Growth Hormone Therapy in Pediatric Growth Hormone Deficiency: A Consensus Statement.

作者信息

Maniatis Aristides, Cutfield Wayne, Dattani Mehul, Deal Cheri, Collett-Solberg Paulo Ferrez, Horikawa Reiko, Maghnie Mohamad, Miller Bradley S, Polak Michel, Sävendahl Lars, Woelfle Joachim

机构信息

Rocky Mountain Pediatric Endocrinology, Centennial, CO 80112, USA.

Liggins Institute, University of Auckland, Auckland 1142, New Zealand.

出版信息

J Clin Endocrinol Metab. 2025 Mar 17;110(4):e1232-e1240. doi: 10.1210/clinem/dgae834.

Abstract

CONTEXT

Several long-acting growth hormone (LAGH) therapies have recently become available, but guidance on their usage in children with growth hormone (GH) deficiency is limited.

METHODS

International experts in pediatric endocrinology were invited to join a consensus group based on their expertise in treating children with daily GH and LAGH. The group comprised 11 experts from 10 countries across the world. Online group meetings were held in February to March 2024 followed by a 1-day in-person meeting in May 2024 to finalize the consensus recommendations. A targeted literature search approach was used to identify and share evidence ahead of the meetings. Formulations considered were limited to those with international populations in phase III pivotal trials and regulatory approvals in multiple countries.

EVIDENCE SYNTHESIS

Topics covered include patient selection and preference, dose adjustment, initiating and switching therapies, administration, adherence and missed doses, practical considerations, and knowledge gaps. LAGH formulations offer a potential advantage over daily GH injections for children with GH deficiency in terms of reduced injection frequency and treatment burden; this may also be associated with improved adherence and treatment outcomes over time. However, data on LAGH in pediatric GH deficiency are mostly limited to clinical trials, and long-term, real-world data are currently lacking.

CONCLUSION

This article provides an international consensus on the use of LAGH therapy in children with GH deficiency to guide practitioners when considering these new treatment options for their patients. Long-term data are needed to fill current data gaps and allow the creation of comprehensive evidence-based recommendations.

摘要

背景

几种长效生长激素(LAGH)疗法最近已可供使用,但关于其在生长激素(GH)缺乏症儿童中的使用指导有限。

方法

邀请国际儿科内分泌学专家加入一个共识小组,基于他们在治疗每日使用GH和LAGH的儿童方面的专业知识。该小组由来自全球10个国家的11名专家组成。2024年2月至3月举行了在线小组会议,随后于2024年5月举行了为期1天的面对面会议,以敲定共识建议。在会议之前,采用了有针对性的文献检索方法来识别和分享证据。所考虑的制剂仅限于那些在III期关键试验中有国际人群且在多个国家获得监管批准的制剂。

证据综合

涵盖的主题包括患者选择和偏好、剂量调整、开始和转换治疗、给药、依从性和漏服剂量、实际考虑因素以及知识差距。对于GH缺乏症儿童,LAGH制剂在减少注射频率和治疗负担方面比每日GH注射具有潜在优势;随着时间的推移,这也可能与更好的依从性和治疗结果相关。然而,关于LAGH在儿童GH缺乏症中的数据大多限于临床试验,目前缺乏长期的真实世界数据。

结论

本文提供了关于LAGH疗法在GH缺乏症儿童中使用的国际共识,以指导从业者在为其患者考虑这些新的治疗选择时提供参考。需要长期数据来填补当前的数据空白,并制定全面的循证建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc58/11913077/6535e3801f1f/dgae834f1.jpg

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