title: Gender-, age- and time-dependent dosing of growth hormone in adults - real-world data from a decade of clinical practice in Germany.
abstract: We evaluated treatment patterns and gender-dependent dosing of growth hormone (GH) substitution in adults with GH deficiency (AGHD). Data on GH dose were collected (2003-2013) from 509 GH-treated patients (mean age: 48.9 years; 47% female) enroled in the observational German NordiWin study (NCT01543880). The impact of gender, age, treatment duration and calendar year on GH treatment patterns was evaluated by multiple regression analysis. Mean (SD) baseline GH dose (mg/day) was similar between females (0.25 [0.19] and males (0.24 [0.15]), but increased with treatment duration (at year 10, 0.55 [0.48] and 0.31 [0.09] in females and males, respectively), reflecting patient dose titration. GH dose increased more in females than males during treatment; this was statistically significant in years 2-6 (p < 0.05). Over the 10-year study period, a time trend of an overall estimated GH dose increase by 0.06 mg/day (females) and decrease by 0.07 mg/day (males) was shown; this interaction of gender and calendar year was significant (p < 0.0001). In both genders, overall GH dose decreased with increasing age (p < 0.0001). Our study confirms that females and younger patients require higher GH doses compared with males and older patients.
authors.affiliation: a Division of Endocrinology and Diabetology, Philipp's University Hospital , Marburg , Germany.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kann
authors.affiliation: a Division of Endocrinology and Diabetology, Philipp's University Hospital , Marburg , Germany.
authors.forename: Simona
authors.initials: S
authors.lastname: Bergmann
authors.affiliation: b Department of Neuroendocrinology, Max-Planck-Institute for Psychiatry , Munich , Germany.
authors.forename: Günter K
authors.initials: GK
authors.lastname: Stalla
authors.affiliation: b Department of Neuroendocrinology, Max-Planck-Institute for Psychiatry , Munich , Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Dimopoulou
authors.affiliation: c Department of Endocrinology and Metabolism, Johannes Gutenberg University Hospital , Mainz , Germany.
authors.forename: Matthias M
authors.initials: MM
authors.lastname: Weber
authors.affiliation: d Epidemiology, Novo Nordisk A/S , Søborg , Denmark , and.
authors.forename: Birgitte T
authors.initials: BT
authors.lastname: Pedersen
authors.affiliation: e Novo Nordisk Pharma GmbH , Mainz , Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Meckes-Ferber
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D004305:Dose-Response Relationship, Drug; D004393:Dwarfism, Pituitary / Q000188:drug therapy*; D005260:Female; D005858:Germany; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone
keywords: Growth hormone deficiency; growth hormone dosing; growth hormone therapy; insulin-like growth factor