Prevalence, Treatment Patterns, and Characteristics of US Adults with Confirmed or at Risk for Growth Hormone Deficiency.

The estimated US prevalence of adult GHD ranged from 0.2 per 100,000 (confirmed) to 37.0 per 100,000 (confirmed plus at-risk).

• Confirmed adult GHD was defined by a GH level < 3 ng/mL on or before index date.
• At-risk individuals had no GH test result but met qualifying criteria such as diagnosis of hypopituitarism or related conditions.
• The wide range reflects uncertainty due to underdiagnosis and lack of routine GH testing.
• Data were drawn from Veradigm Network electronic health records linked to claims between January 1, 2017 and December 31, 2021.

A total of 268 individuals had confirmed adult GHD and 54,310 were at risk for adult GHD in the study population.

• Confirmed adult GHD was defined as GH level < 3 ng/mL on or before index date.
• At-risk individuals had no GH test result recorded.
• A separate ruled-out group had GH levels ≥ 3 ng/mL.
• Mean age was approximately 50 years old across both confirmed and at-risk groups.
• A majority of individuals in both groups were female.

GH treatment was initiated in only 9.7% of confirmed adult GHD individuals and 3.1% of those at risk for adult GHD.

• These low treatment initiation rates suggest substantial undertreatment of the condition.
• Treatment initiation was assessed during the follow-up period after index date.
• The study used Veradigm Network EHR data linked to claims to identify GH prescriptions.
• The difference in treatment rates between confirmed and at-risk groups likely reflects the role of diagnostic confirmation in treatment decisions.

Among individuals who initiated GH treatment, only 32.2% were persistent with treatment until the end of the follow-up period.

• This low persistence rate was observed across both confirmed and at-risk individuals who initiated treatment.
• Treatment persistence was assessed from treatment initiation to end of follow-up.
• Low persistence may contribute to suboptimal management of adult GHD.
• The study did not separately report persistence rates for confirmed versus at-risk subgroups in the abstract.

Prevalence of endocrine-related conditions was higher in treated individuals, while metabolic and cardiovascular comorbidities were more prevalent in untreated individuals.

• This pattern was observed among both confirmed and at-risk adult GHD individuals.
• Higher endocrine comorbidity burden in treated patients may reflect a more complete diagnostic workup leading to treatment initiation.
• Higher metabolic and cardiovascular comorbidities in untreated individuals may indicate underrecognition of GHD consequences or barriers to treatment.
• Specific comorbidities examined included conditions related to metabolic and cardiovascular health, though exact conditions are not enumerated in the abstract.

The study identified adults with high likelihood of adult GHD using a multi-criteria algorithm applied to linked EHR and claims data.

• Qualifying criteria included ≥ 1 diagnosis of hypopituitarism or ≥ 1 related condition such as Cushing disease, ≥ 3 pituitary hormone deficiencies other than GHD, ≥ 3 pituitary hormone treatments other than GH, or ≥ 1 prescription for GH between January 1, 2017 and December 31, 2021.
• Index date was defined as the earliest qualifying event.
• Individuals were stratified into confirmed (GH < 3 ng/mL), at-risk (no test result), and ruled-out (GH ≥ 3 ng/mL) groups.
• The data source was the Veradigm Network electronic health records linked to claims.