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Adult growth hormone deficiency: clinical advances and approaches to improve adherence

Yuen, K. C. J., Llahana, S. ORCID: 0000-0002-3606-5370 & Miller, B. S. (2019). Adult growth hormone deficiency: clinical advances and approaches to improve adherence. Expert Review of Endocrinology & Metabolism, doi: 10.1080/17446651.2019.1689119


Introduction: There have been significant clinical advances in the understanding of the diagnosis and benefits of long-term recombinant human growth hormone (rhGH) replacement in adults with GH deficiency (GHD) since its approval in 1996 by the United States Food and Drug Administration.

Areas covered: We searched PubMed, Medline, CINAHL, EMBASE and PsychInfo databases between January 2000 and June 2019 for published studies evaluating adults with GHD. We reviewed the data of the oral macimorelin test compared to the GHRH plus arginine and the insulin tolerance tests that led to its approval by the United States FDA and European Medicines Agency for adult diagnostic testing. We summarize the clinical advances of long-term benefits of rhGH therapy and the potential effects of GH receptor polymorphisms on individual treatment responsiveness. We identify that non-adherence and discontinuation rates are high and recommend strategies to support patients to improve adherence. We also provide an overview of several long-acting GH (LAGH) preparations currently under development and their potential role in improving treatment adherence.

Expert opinion: This article summarizes recent clinical advances in rhGH replacement therapy, the biological and molecular aspects that may influence rhGH action, and offers practical strategies to enhance adherence in adults with GHD.

Publication Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Review of Endocrinology & Metabolism on 4 Nov 2019, available online:
Publisher Keywords: Growth hormone, adult growth hormone deficiency, advances, adherence, long-acting growth hormone
Subjects: R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences > Nursing
Text - Accepted Version
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