“We were surprised and pleased to find that the patients had a reduced risk of fracture so many years after the growth hormone treatment was ceased,” Dr. Emily Krantz, from Sodra Alvsborgs Hospital, Boras, Sweden, told Reuters Health by email.
“We were also surprised that quality of life (QoL) was constant throughout the entire follow-up time for all the treatment groups and that there was no difference between the patients and the control group,” she said.
In an earlier study of women with postmenopausal osteoporosis who received growth hormone for three years, bone mineral content improved and remained 14% higher one year after growth hormone was terminated.
Dr. Krantz’s team now report bone data, fractures, and QoL in 80 of these women who were evaluated at the 10-year follow-up. All women received calcium and vitamin D and hormone replacement therapy.
In both growth hormone treatment groups (1.0 U and 2.5 U), serum IGF-1 increased during the trial and decreased to baseline levels when growth hormone was terminated after three years.
Bone mineral density and bone mineral content remained increased at four and five years in the growth hormone-treated groups, but by 10 years had decreased to baseline levels. They remained higher, however, in the 2.5 U growth hormone group than in the 1.0 U growth hormone group and in controls.
Just over half (56%) of the women had experienced fractures before inclusion in the study, but during the seven years after growth hormone was stopped, only 28% of women experienced fractures, according to the Aug. 27 online report in the Journal of Clinical Endocrinology & Metabolism.
In comparison, 8% of 120 population controls had suffered a fracture before, and 32% of population controls experienced fractures during the same study period.
Quality of life did not change significantly during growth hormone treatment, but it decreased with increasing age and was similar in patients and controls both at the start of the study and 10 years later.
“Today growth hormone is an expensive treatment, and although it is injected daily by the patients themselves, regular monitoring must be overseen by a specialist clinic, which is not in its favor when considering it in a practical clinical setting,” Dr. Krantz said.
“But osteoporosis is a severely undertreated disease and more must be done to discover at-risk patients and to tailor their treatment. I think that if growth hormone had existed in a long-acting preparation, so that it could be given once a week or once a month, that it could be of interest for this patient group,” she said.