ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P450

The benefit of long-term growth hormone replacement therapy in adults, results of the German KIMS database

Christin Albrecht1, Michael Buchfelder2, Walter Faßbender3, Michael Faust4, Peter Kann5, Ilonka Kreitschmann-Andermahr6, Thomas Kohlmann7, Maria Kołtowska-Häggström8 & Henri Wallaschofski9

1Department of Gastroenterology, University of Greifswald, Endocrinology and Nutrition, Greifswald, Germany; 2Department of Neurosurgery, University of Erlangen, Erlangen, Germany; 3Department of Internal Medicine, Kempten, Germany; 4Department of Endocrinology, University of Köln, Köln, Germany; 5Department of Endocrinology, University of Marburg, Marburg, Germany; 6Department of Neurosurgery, University of Aachen, Aachen, Germany; 7Community Medicine, University of Greifswald, Greifswald, Germany; 8KIMS Medical Outcomes, Pfizer Endocrine Care, Department of Pharmacy, Uppsala University, Sollentuna, Uppsala, Sweden; 9Department of Gastroenterology, Endocrinology and Nutrition, University of Greifswald, Greifswald, Germany.

Objective: The German KIMS Database is a national surveillance study for evaluation of efficacy and safety of growth hormone (GH) replacement therapy in adults with GH deficiency (GHD) in clinical practice.

Patients: The analysis was performed using data of 1425 consecutively documented adult patients (777 men, 648 women) with GHD enrolled in KIMS Germany. The present report examined baseline and long term data (>48 months, range: 48–161 month) from a subset of 780 of these patients (420 men, 360 women) with GH deficiency aged 20–75 (median 44) years. Patients have been assigned to sex and age-related groups (20–39, 40–59 and 60–79 years). Patients were examined for serum IGF-1, blood glucose and lipid profile at baseline and at last visit. Furthermore QoL-AGHDA score has been determined for quality of live assessment. Most of the patients required additional pituitary replacement and were on optimal doses at recruitment.

Results: The IGF-1 and IGF-1 SDS-levels increased in all groups significantly (P<0.001). After GH therapy serum total cholesterol and low-density lipoprotein (LDL) decreased in males (Δ −0.2 mg/dl, P<0.005) and females (Δ −0.2 mg/dl, P<0.005) significantly. Blood glucose increased from 4.7 to 4.9 mmol/l (P<0.01) and in 15 patients the development of diabetes has been observed. The QoL-AGHDA score improved from 8 to 3 (P<0.001) in all groups significantly. Moreover we detected no influence of seasons on quality of live assessment. During the treatment recurrences of pituitary tumors n=44 (5.6%) or further neoplasia n=23 (2.9%) have been observed.

Conclusion: Therefore, these observational data showed significant long-term efficacy of adult GH replacement therapy on IGF-1, lipid profile as well as quality of life.