Long-term Effectiveness and Safety of GH Replacement Therapy in Adults 60 Years: Data From NordiNet? IOS and ANSWER

Context Effectiveness and safety data on GH replacement therapy (GHRT) in older adults with adult GH deficiency (AGHD) are limited. Objective To compare GHRT safety and clinical outcomes in older (>= 60 years and, for some outcomes, >= 75 years) and middle-aged (35-<60 years) patients with AGHD. Design/setting Ten-year follow-up, real-world data from 2 large noninterventional studies-NordiNet (R) International Outcome Study (IOS) and the American Norditropin (R) Studies: Web-Enabled Research (ANSWER) Program-were analyzed. Patients GH-naive and non-naive patients with AGHD. Intervention Norditropin (R) (somatropin). Main outcome measures Outcomes included GH exposure, IGF-I standard deviation scores (SDS), body mass index (BMI), glycated hemoglobin (HbA(1c)), serious and nonserious adverse reactions (SARs and NSARs, respectively), and serious adverse events (SAEs). Adverse reactions were events with possible/probable causal relationship to GHRT. Results The effectiveness analysis set comprised 545 middle-aged and 214 older patients (19 aged >= 75 years) from NordiNet (R) IOS. The full analysis set comprised 1696 middle-aged and 652 older patients (59 aged >= 75 years) from both studies. Mean GH doses were higher in middle-aged vs older patients. For both age groups and sexes, mean IGF-I SDS increased following GHRT, while BMI and HbA(1c) changes were similar and small. Incidence rate ratios (IRRs) did not differ statistically between older and middle-aged patients for NSARs [IRR (mean, 95% confidence interval) 1.05 (.60; 1.83)] or SARs [.40 (.12; 1.32)]. SAEs were more frequent in older than middle-aged patients [IRR 1.84 (1.29; 2.62)]. Conclusion Clinical outcomes of GHRT in AGHD were similar in middle-aged and older patients, with no significantly increased risk of GHRT-related adverse reactions in older patients.