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Dose Titration and Monitoring GH Treatment in the Adult

  • Chapter
Growth Hormone

Part of the book series: Endocrine Updates ((ENDO,volume 4))

Abstract

Increasingly, growth hormone (GH) replacement is being offered to adults with severe GH deficiency (GHD). Initial reports of the benefits of GH therapy (23, 35) in the adult GHD population were based on trials using doses of GH comparable to those which had been used for years in paediatric practice. Whilst most studies demonstrated benefits of GH therapy, two observations suggested that in adults these doses were supraphysiological. Firstly, compared with children, the incidence of side effects in adults was greater and often responded to a dose reduction. Salomon et al (35) reported side effects of fluid retention, arthralgia or myalgia in more than half of the patients they treated with 0.07 IU/kg/day of GH. Furthermore a review by De Boer (10) of several studies published between 1989 and 1993 demonstrated that 61% of patients treated with GH at a dose of above 2.5 IU/ m2/day reported side effects. Secondly a proportion of patients had IGF-1 levels above the normal range suggesting over-treatment. In 1993 Moller et al (27) demonstrated a dose-dependent rise in IGF-1 levels during treatment of GHD adults, with markedly elevated levels following 4 IU/ m2/day of GH. More recent studies have confirmed raised IGF-1 levels in patients receiving high dose GH replacement (8,11,27).

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Authors and Affiliations

  1. Department of Endocrinology, Christie Hospital NHS Trust, Withington, Manchester, UK

    S J Howell MRCP, A Rahim MRCP & S M Shalet MD FRCP

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  1. S J Howell MRCP
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  2. A Rahim MRCP
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  3. S M Shalet MD FRCP
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Editors and Affiliations

  1. Sahlgrenska University Hospital, Göteborg, Sweden

    Bengt-Åke Bengtsson M.D.

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© 1999 Springer Science+Business Media New York

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Howell, S.J., Rahim, A., Shalet, S.M. (1999). Dose Titration and Monitoring GH Treatment in the Adult. In: Bengtsson, BÅ. (eds) Growth Hormone. Endocrine Updates, vol 4. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5163-8_18

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  • DOI: https://doi.org/10.1007/978-1-4615-5163-8_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7351-3

  • Online ISBN: 978-1-4615-5163-8

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