Endocrine Abstracts

JOINT797

Background: Long-acting growth hormone (LAGH) therapy has revolutionized treatment for growth hormone deficiency (GHD) by enhancing adherence and reducing the frequency of injections compared to daily GH therapy. However, sustained non-pulsatile GH and IGF-I levels, differing from physiological pulsatile secretion, may raise long-term safety and metabolic concerns. This review evaluates the efficacy, serum GH and IGF-I impacts, and safety risks of LAGH therapy relative to daily GH and physiological secretion patterns.

Objectives: 1. To assess the clinical efficacy of LAGH in promoting growth and IGF-I regulation. 2. To explore its safety profile, particularly metabolic and proliferative risks, compared to daily GH therapy. 3. To provide quantifiable insights into the percent impact of LAGH therapy across key categories: height SDS improvement, IGF-I level changes, and safety.

Methods: A comprehensive literature review of studies published between 2006 and 2025 was conducted. Data on height SDS improvements, IGF-I level changes, and reported safety events were extracted and analyzed. Studies were categorized and impact percentages were calculated based on clinical outcomes and safety metrics.

Results: • Efficacy:

LAGH therapy demonstrated an average 12% improvement in height SDS, with efficacy comparable to daily GH therapy (Miller et al., 2020; Kang et al., 2024).

• IGF-I Monitoring:

Sustained IGF-I levels increased by 23% on average, highlighting significant metabolic activity, but requiring careful monitoring to mitigate risks of excessive exposure (Bidlingmaier & Schilbach, 2021; van Dijk et al., 2006).

• Safety Concerns:

Safety events, inversely scored for impact, were relatively low at 4 per 100 patients, with no severe adverse outcomes reported in recent trials (Savendahl et al., 2022; Bruzzi et al., 2023).

• Patient Adherence:

LAGH improved patient adherence and accessibility, reducing injection burden and enhancing treatment satisfaction (Steiner et al., 2023; Boguszewski et al., 2024).

• Long-Term Needs:

Personalized dosing and regular IGF-I monitoring are essential to mimic physiological GH secretion (Clemmons, 2007; Bruzzi et al., 2023).

Discussion: While LAGH therapy offers significant clinical benefits, sustained non-pulsatile GH and IGF-I levels deviate from natural physiology, posing potential risks such as glucose intolerance and proliferative disorders. Percent impact analysis reveals notable gains in height and IGF-I levels, with minimal safety concerns, affirming the therapy’s efficacy. However, long-term safety monitoring remains essential.

Conclusion: LAGH therapy is a viable alternative to daily injections, delivering notable improvements in growth and IGF-I levels with minimal safety concerns. Optimized dosing and ongoing research are critical to aligning LAGH therapy with physiological GH dynamics.