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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Case example of adult-onset GHD
- Case 1 discussion points
- Public, provider and payer perceptions and insurance barriers of adult GHD
- Adult GHD syndrome first described in 1992
- History for indications of GH therapy in the US
- What is adult GHD and why treat?
- Who to screen for adult GHD?
- Testing for adult GHD is often complex and challenging
- AACE 2019 CPG algorithm for testing adults with clinical suspicion of GHD
- Distinct peak GH cut-off of ITT
- Caveats of GH stimulation tests
- Practical challenges when undergoing GH stimulation tests
- Summary of pros and cons of GH stimulation tests
- Recommendations for starting GH doses in adults with GHD
- Effects of GH on glucose metabolism in adults with GHD: high doses
- Effects of GH on glucose metabolism in adults with GHD: low doses
- Low dose GH therapy
- Use of GH for anti-aging
- Potential impact of untreated GHD vs benefits of GH replacement on CV risk markers
- Mortality in adult GHD
- Long-term effects of GH
- Case example of childhood-onset GHD
- Case 2 discussion points
- AACE 2019 CPG algorithm for testing transition patients with clinical suspicion of GHD
- High prevalence of undiagnosed GHD in transition patients
- Effects of long-term GH replacement on secondary neoplasms
- Safety concerns regarding long-term GH replacement on secondary neoplasms
- Use of GH for fertility and during pregnancy
- Use of GH for sports
- Why consider LAGH preparations?
- How do we make GH action last longer?
- Overall treatment effects & safety of Somapacitan
- LAGH preparations more convenient and preferred by patients than daily GH injections
- Measuring IGF-I levels while on LAGH preparations
- Concerns unique to LAGH preparations
- ESE audit on management of adult GHD in clinical practice
- What has the ESE audit taught us?
- Diagnosis and treatment journeys from patients’ perspective
- Outstanding knowledge and treatment gaps of daily GH
- Conclusions
- Thank you for your attention!
Topics Covered
- Adult GHD diagnosis
- Adult GHD treatment
- Screening of adult GHD
- AACE 2019 CPG algorithm
- Pros and cons of GH stimulation tests
- Starting doses recommendations in GHD adults
- Use of GH for anti-aging
- Long-term effects of GH
- High prevalence of undiagnosed GHD in transition patients
- Use of GH for fertility and during pregnancy
- Use of GH for sports
- LAGH preparations
Links
Categories:
Therapeutic Areas:
Talk Citation
Yuen, K.C. (2023, September 28). Adult growth hormone deficiency: current understanding, diagnosis and treatment [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 11, 2024, from https://doi.org/10.69645/IOTU1775.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Yuen received research grants to Barrow Neurological Institute from Corcept, Chiesi and Sparrow; served as an occasional advisory board member for Recordati and Xeris; and is an occasional speaker for Recordati.
Adult growth hormone deficiency: current understanding, diagnosis and treatment
Published on September 28, 2023
36 min
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
Hello. My name is Kevin Yuen.
I'm the Professor of
Medicine and Medical
Director of the Barrow
Neurological Institute,
Pituitary Center in
Phoenix, Arizona.
Today my talk to you is titled,
Adult Growth Hormone
Deficiency: Current
Understanding Diagnosis
and Treatment.
0:20
These are my disclosures.
0:24
So for my talk today,
I would like to start off with
a case example of a patient that
presented to me recently with
adult onset growth
hormone deficiency.
He's a 54 year old male with
Non-Functioning Pituitary
Adenoma, underwent pituitary
surgery four years ago,
and stereotactic radiosurgery
three years ago.
Now he has underlying TSH
and ACTH deficiencies,
for which he is on stable doses
of levothyroxine
and hydrocortisone.
At his most recent clinic
follow up appointment,
he had a blood test where
his IGF one standard
deviation score was -1.7.
His main complaint now is that
he's noticing some
weight gain of
ten pounds over the
past six months
and increased fatigue.
He does have a family history of
osteoporosis,
hyperlipidemia and cancer.
He has read up on the Internet
about the condition called
adult growth hormone
deficiency and would
like to be considered
for treatment for this.
1:23
For this patient, what
are the discussion points
that one needs to be considering
when seeing this patient?
On this slide here
you can see that
the condition adult growth
hormone deficiency and why
treat it certainly
something that needs to be
addressed then followed
by who to screen,
how to screen, and
once the patient has
confirmed adult growth
hormone deficiency,
how to start growth
hormone therapy,
and how to monitor
treatment efficacy.
There's also the issue of
discussing with
the patient about
potential safety concerns with
long term growth
hormone replacement
and also potential use or
misuse of growth
hormone replacement
for anti aging purposes.
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