Quality of Life in Adult Growth Hormone Deficiency

Publisher Summary It is noted that growth hormone deficiency (GHD) hypopituitary adults have impaired quality of life (QoL). There are a number of additional factors apart from GH which contribute to the overall psychological and physical well-being of these patients. Early treatment studies used weight-based dosing regimens extrapolated from pediatric practice that results in a high proportion of side effects and withdrawals. Results of these studies show only minor improvements in QoL within self-rating questionnaire subscales rather than in overall scores. This may, in part, be the consequence of side effects detracting from the potential benefit of GH therapy. Later studies have generally been undertaken in the form of open treatment studies. Open studies have mostly documented a beneficial effect of GH on QoL but suffer from a placebo effect, regression to the mean, and patient selection biases. Long-term studies show that the beneficial effect of GH is likely maintained, although patient selection biases may have influenced the findings of these open studies. GHD long-term survivors of childhood cancer seem to benefit from GH replacement to a similar extent as hypopituitary patients, whereas the benefit to elderly GHD adults remains unclear.