Influence of long-acting growth hormone analogs on other hypothalamic-pituitary axes: a real-world study
- 1Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- 2Department of Clinical Sciences and Community Health, Department of Excellence 2023- 2027, University of Milan, Milan, Italy
Abstract
Introduction/purpose: Long‑acting growth hormone (LAGH) formulations have emerged to address poor adherence to daily recombinant human growth hormone (rhGH), offering reduced injection frequency and comparable efficacy. Though their efficacy and safety in children have been demonstrated in registrative trials and in some real-world studies, their impact on other pituitary axes remains unclear.
Methods: This observational prospective monocentric study explores hormonal changes in isolate growth hormone deficiency (GHD) children (n = 33) starting LAGH Somatrogon (n = 16, G1) or switching from daily rhGH to the same weekly analogue (n = 17, G2). In all study patients, baseline and post‑treatment assessments (after 3–6 months of weekly LAGH start) included IGF‑I, ACTH, cortisol, TSH, FT4 and FT3 levels.
Results: After LAGH initiation, IGF‑I SDS increased significantly in both groups (p < 0.001), more frequently exceeding 2 SDS in G2 (6/17 vs. 2/16 in G1). No significant changes occurred in TSH, FT3, FT4, ACTH or cortisol levels after LAGH start, nor between‑group differences.
Conclusions: In isolated GHD, adrenal and thyroid function remained stable after LAGH initiation, with comparable results in treatment‑naïve patients and in those already receiving daily therapy. A greater increase in IGF-I levels was observed in switchers, suggesting that a lower starting dose may be appropriate in patients previously treated with rhGH. Further studies are required to clarify the endocrine effects of long‑acting formulations in individuals with associated multiple pituitary hormone deficiencies.
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BibTeX
@article{rodari2026influence,
title = {{Influence of long-acting growth hormone analogs on other hypothalamic-pituitary axes: a real-world study}},
author = {Giulia Rodari and Eriselda Profka and Aurora Pedroli and Valeria Citterio and Valentina Collini and Camilla Mazzi and Giovanna Mantovani and Claudia Giavoli},
journal = {Journal of Endocrinological Investigation},
year = {2026},
month = jul,
doi = {10.1007/s40618-026-02986-1},
url = {https://doi.org/10.1007/s40618-026-02986-1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Influence of long-acting growth hormone analogs on other hypothalamic-pituitary axes: a real-world study
AU - Giulia Rodari
AU - Eriselda Profka
AU - Aurora Pedroli
AU - Valeria Citterio
AU - Valentina Collini
AU - Camilla Mazzi
AU - Giovanna Mantovani
AU - Claudia Giavoli
PY - 2026
DA - 2026/07/29
JO - Journal of Endocrinological Investigation
DO - 10.1007/s40618-026-02986-1
UR - https://doi.org/10.1007/s40618-026-02986-1
AB - Introduction/purpose: Long‑acting growth hormone (LAGH) formulations have emerged to address poor adherence to daily recombinant human growth hormone (rhGH), offering reduced injection frequency and comparable efficacy. Though their efficacy and safety in children have been demonstrated in registrative trials and in some real-world studies, their impact on other pituitary axes remains unclear. Methods: This observational prospective monocentric study explores hormonal changes in isolate growth hormone deficiency (GHD) children (n = 33) starting LAGH Somatrogon (n = 16, G1) or switching from daily rhGH to the same weekly analogue (n = 17, G2). In all study patients, baseline and post‑treatment assessments (after 3–6 months of weekly LAGH start) included IGF‑I, ACTH, cortisol, TSH, FT4 and FT3 levels. Results: After LAGH initiation, IGF‑I SDS increased significantly in both groups (p < 0.001), more frequently exceeding 2 SDS in G2 (6/17 vs. 2/16 in G1). No significant changes occurred in TSH, FT3, FT4, ACTH or cortisol levels after LAGH start, nor between‑group differences. Conclusions: In isolated GHD, adrenal and thyroid function remained stable after LAGH initiation, with comparable results in treatment‑naïve patients and in those already receiving daily therapy. A greater increase in IGF-I levels was observed in switchers, suggesting that a lower starting dose may be appropriate in patients previously treated with rhGH. Further studies are required to clarify the endocrine effects of long‑acting formulations in individuals with associated multiple pituitary hormone deficiencies.
SN - 0391-4097
SN - 1720-8386
ER -