GHD women might be treated suboptimally, reflected as lower IGF-1 status and lower GHRT tolerability, leading to more frequent changes in treatment regimen but not discontinuation of GHRT, while GHD men had a higher risk for development of malignancies.
Key Findings
Results
IGF-1 SD scores remained subnormal more often in women during GH replacement therapy, while scores above normal were more frequent in men.
Sensitivity analysis showed IGF-1 SD scores remained subnormal more often in women (P < 0.001)
IGF-1 SD scores above normal were more frequent in men (P < 0.001)
Study included 1335 GHD men and 1251 GHD women treated with GHRT
Data were obtained from the Dutch National Registry of GH Treatment in Adults
Results
Women reported more adverse events during GHRT, especially symptoms related to fluid retention.
Women reported more adverse events compared to men (P < 0.001)
Adverse events were especially symptoms related to fluid retention
Women more often needed a dose reduction or temporary stop of GHRT (P = 0.001)
Despite more adverse events and treatment modifications, both sexes discontinued GHRT at equal percentages
Results
The risk of developing malignant neoplasms during GHRT was higher in men than in women.
The risk of developing malignant neoplasms was higher in men (P = 0.012)
Both sexes had equal risk in developing type 2 diabetes mellitus, benign neoplasms, and tumor recurrence
Study design was a retrospective cohort study at a nationwide outpatient clinic
Results
Both sexes discontinued GHRT at equal percentages despite differences in tolerability and treatment modifications.
In percentages, both sexes equally discontinued GHRT
Women more often needed dose reduction or temporary stop of GHRT (P = 0.001) but did not discontinue at higher rates
This finding was observed in a cohort of 1335 men and 1251 women
Background
Previous studies have reported that outcomes of GH replacement therapy might be less beneficial in GHD women compared with men.
This finding from prior literature motivated the current retrospective cohort study
The study investigated possible contributing factors regarding this previously found sex difference
The study was conducted using data from the Dutch National Registry of GH Treatment in Adults
Patient baseline characteristics, GHRT details, tolerability, and long-term safety were all measured as outcomes
Slagboom T, van Bunderen C, van der Lely A, Drent M. (2023). Sex Differences in Long-Term Safety and Tolerability of GH Replacement Therapy in GH Deficient Adults.. The Journal of clinical endocrinology and metabolism. https://doi.org/10.1210/clinem/dgad013