Long-acting growth hormone: An updated Growth Hormone Research Society consensus statement.
LAGH preparations show comparable efficacy to daily somatropin, but careful patient selection and monitoring are crucial.
Where it sits
this study against the rest of the hgh (somatropin) corpusSummary and findings
This consensus statement reviews long-acting growth hormone (LAGH) preparations, focusing on their use in pediatric growth hormone deficiency and adult GHD. Data from over 8,000 individuals treated with LAGH for up to 7 years were evaluated. The efficacy of LAGH appears comparable to daily somatropin when dosing is individualized.
Abstract
Long-acting growth hormone (LAGH) preparations have moved from development to routine clinical use over the past decade. Several products are now approved for paediatric growth hormone deficiency (GHD), selected non-GHD short-stature indications, and, in some regions, for adult GHD. The Growth Hormone Research Society convened an international workshop in October 2025 to reappraise the evidence base and refine clinical recommendations. Currently, data are available for up to 7 years of LAGH treatment in over 8,000 individuals. This remains substantially shorter and smaller than for daily GH. Across preparations, short- to mid-term efficacy appears comparable to daily somatropin, provided dosing is individualised and monitored appropriately. Approvals and pivotal trials include both, treatment initiation and switching from daily GH, depending on product and regional label. No new major safety signals have been identified in trials and real-world reports, although data on BMI trajectories require further evaluation. Injection-site reactions remain the most frequent adverse event and vary by formulation. Anti-drug-antibodies have been observed, yet evidence suggests they have limited clinical impact. Effects on glucose metabolism resemble those of daily therapy, but metabolically high-risk groups are under-represented in studies. Among cancer survivors, data on tumour recurrence and second neoplasms with LAGH are not yet available. Recommendations and practice points emphasised careful patient selection and counselling, product-specific dosing, and insulin-like growth factor-I (IGF-I) monitoring. Urgent knowledge gaps include transition care, long-term efficacy, adherence and safety in cancer survivors. Well-resourced registries are essential for addressing these gaps and supporting safe, effective, and patient-centred use of LAGH.
Background
This paper addresses the clinical use of long-acting growth hormone (LAGH) preparations, which have transitioned from development to routine clinical use over the past decade. Prior knowledge indicated that daily growth hormone therapy was the standard, but LAGH offers potential benefits in convenience and adherence. This study is significant as it aims to refine clinical recommendations based on a comprehensive review of available evidence.
Methods
The consensus statement is based on an international workshop held in October 2025, reviewing existing data on LAGH. The population includes over 8,000 individuals treated with LAGH, with a focus on pediatric growth hormone deficiency and adult GHD. The duration of treatment reported extends up to 7 years, but specific dosing and administration routes are not detailed in the abstract.
Results
The primary endpoint indicates that short- to mid-term efficacy of LAGH is comparable to daily somatropin, contingent on individualized dosing and monitoring. No new major safety signals have been identified, although injection-site reactions are noted as the most frequent adverse event. The abstract does not provide specific p-values or confidence intervals for these findings.
Interpretation
The findings suggest that LAGH could be a viable alternative to daily growth hormone therapy, particularly in terms of efficacy. However, the absence of long-term data and the under-representation of high-risk metabolic groups limit the conclusions that can be drawn. This highlights the need for careful patient selection and ongoing monitoring in clinical practice.
Key findings
- Data available for up to 7 years of LAGH treatment in over 8,000 individuals.
- Short- to mid-term efficacy appears comparable to daily somatropin.
- Injection-site reactions remain the most frequent adverse event.
- Anti-drug-antibodies have been observed but evidence suggests limited clinical impact.
Limitations
- Data on BMI trajectories require further evaluation.
- Metabolically high-risk groups are under-represented in studies.
- No new major safety signals identified, but injection-site reactions are common.
- Data on tumor recurrence in cancer survivors with LAGH are not yet available.