01 Sep Growth Hormone Reduced Fractures in Osteoporosis Patients
MedicalResearch.com Interview with:
Emily Krantz (né Amundson) MD
Södra Älvsborgs Hospital
Medical Research: What is the background for this study? What are the main findings?
Response: This study is a 10-year follow up of a double-blind placebo controlled trial in which women with post menopausal osteoporosis received Growth Hormone (GH) for 3 years (Landin-Wilhelmsen JBMR 2003;18:393-404). Positive effects of the treatment on the patients bone mineral density and bone mineral content were seen after another 7 years. Furthermore and most interestingly, fracture incidence decreased dramatically from 56% to 28% (p=.0003) in the osteoporosis patients while fractures increased significantly in the control group, from 8% to 32% (p=.0008). Health Related Quality of Life was also measured throughout the study’s duration and it did not change nor did it differ from the control group.
Medical Research: What should clinicians and patients take away from your report?
Response: This study is, to our knowledge, the largest and longest controlled study with Growth Hormone treatment in postmenopausal osteoporosis. The Growth Hormone treatment had a sustained effect on reducing the patients fracture risk 7 years after the treatment ceased which has not been shown before. Since the trial was done, other bone specific, anabolic osteoporosis treatments have come into use, for example Teriparatide for severe osteoporosis and fractures, and Denosumab. Still, the first line drug is bisphosphonates, which is the most common treatment. Today Growth Hormone is an expensive treatment, although the injections are taken by the patients themselves, it must be monitored by a specialist clinic, which is not in its favor when considering it in a practical clinical setting. But osteoporosis is a severely undertreated disease and more must be done to discover 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. In addition to GH’s positive effect on bone tissue, Landin-Wilhelmsen K et al (see ref above) have shown that it has a positive effect on muscle mass, which leads to better body balance. Better balance reduces the risk for falls, which reduces the risk of fractures, which is the ultimate goal regardless of which drug is in question.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: If Growth Hormone is to be a feasible treatment as an addition to Calcium, Vitamin D and Bisphosphonates for patients with severe manifest osteoporosis in ”the real world”, a long-acting preparation would be desirable. Furthermore, more and larger trials need to be done and it’s safety assessed.
Emily Krantz, Penelope Trimpou, Kerstin Landin-Wilhelmsen. Effect of Growth Hormone Treatment on Fractures and Quality of Life in Postmenopausal Osteoporosis: A 10-Year Follow-Up Study. The Journal of Clinical Endocrinology & Metabolism, 2015; jc.2015-1757 DOI:10.1210/jc.2015-1757
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MedicalResearch.com Interview with:, & Emily Krantz (né Amundson) MD (2015). Growth Hormone Reduced Fractures in Osteoporosis Patients MedicalResearch.com