SAT611 Prevalence Of Comorbidities Among Treated And Untreated Adults With Suspected Growth Hormone Deficiency

Andrew R. Hoffman, S. Raveendran,Janna Manjelievskaia, Allison Komirenko,Machaon Bonafede, Isabelle Winer, Jennifer Cheng, Philip B. Miner,Alden Smith

Journal of the Endocrine Society(2023)

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Abstract Disclosure: A.R. Hoffman: Consulting Fee; Self; Ascendis. S. Raveendran: Employee; Self; Ascendis Pharma. J. Manjelievskaia: Employee; Self; Veradigm. Research Investigator; Self; Veradigm. A. Komirenko: Employee; Self; Ascendis Pharma. M. Bonafede: Employee; Self; Veradigm. Research Investigator; Self; Veradigm. Stock Owner; Self; Veradigm. I. Winer: Employee; Self; Veradigm. Research Investigator; Self; Veradigm. J. Cheng: Employee; Self; Veradigm. Research Investigator; Self; Veradigm. P. Miner: Employee; Self; Ascendis Pharma. A.R. Smith: Employee; Self; Ascendis Pharma. Introduction: Adult growth hormone deficiency (AGHD) is associated with an increased risk of morbidity and mortality, yet is known to be underdiagnosed and undertreated. Untreated or undertreated patients with AGHD can experience reduced quality of life, adverse changes in metabolic and cardiovascular (CV) function, and increased risk of other comorbidities. This study captured and described suspected AGHD cases based on a previously published algorithm in order to characterize the treatment rate and clinical burden of this disease. Methods: Using the Veradigm Network EHR database linked to administrative claims, this retrospective cohort study selected adult patients with suspected AGHD between 1/1/2017 and 12/31/2021 based on: hypopituitarism diagnosis or ≥1 diagnosis for related conditions, ≥3 pituitary hormone deficiencies, ≥3 replacement therapies with pituitary hormones or vasopressin, or ≥1 prescription for GH. Index date was based on the earliest qualifying event. Baseline demographics and clinical characteristics were assessed throughout the 12-month baseline period. Receipt of GH treatment was assessed throughout the 12-month baseline and 12-month follow-up periods. Results: Of the 51,588 patients with suspected AGHD, 59% were female, median age was 51 years, and 59% were White. About 3.2% had evidence of GH therapy during the study period. Among the 1,659 GH-treated patients, 40% were treated during both baseline and follow-up. Median age among treated patients was 48 years and 53% were male. At baseline, the top clinical comorbidities among the overall cohort were CV disease (52%), hyperlipidemia (47%), endocrine-related conditions (45%), mental health conditions (43%), and sleep disorders (29%). Treated adults had higher proportions of endocrine-related conditions (66% vs 44%), the most prevalent of which were hypopituitarism (38% vs 6%), hypothyroidism (37% vs 29%), and hypogonadism (27% vs 17%) compared to untreated. Higher proportions of CV disease (52% vs 36%), hyperlipidemia (47% vs 36%), obesity (35% vs 20%), diabetes mellitus (27% vs 15%), and liver disease (14% vs 11%) were observed in the untreated vs treated cohort. Prevalence of depression, anxiety, and sleep disorders was observed in about a third of both cohorts (treated and untreated). Conclusions: Most adults with suspected GHD remain untreated. Fewer than 4% of suspected AGHD patients in our study were treated with GH. Substantially higher proportions of clinical conditions related to metabolic and CV function were observed among the untreated cohort supporting the need for improved diagnosis and management of this disease. Presentation: Saturday, June 17, 2023
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关键词
deficiency,comorbidities,untreated adults,prevalence
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