ESE audit on management of adult growth hormone deficiency in clinical practice
Martel-Duguech, Luciana (Institut d'Investigació Biomèdica Sant Pau)
Jorgensen, Jens Otto Lunde (Department of Clinical Medicine. Department of Endocrinology and Diabetes)
Korbonits, Marta (Queen Mary University of London)
Johannsson, Gudmundur (University of Gothenburg)
Webb, S. M 1952- (Institut d'Investigació Biomèdica Sant Pau)
Adamidou, Fotini (Hippokration General Hospital of Thessaloniki)
Mintziori, Gesthimani (Hippokration General Hospital of Thessaloniki)
Arosio, Maura (University of Milan)
Giavoli, Claudia (University of Milan)
Badiu, Corin (National Institute of Endocrinology 'C. Davila')
Boschetti, Mara (University of Genoa)
Ferone, Diego (University of Genoa)
Bitti, Silvia Ricci (University of Genoa)
Brue, Thierry (Aix-Marseille Université)
Albarel, Frederique (Aix-Marseille Université)
Cannavo, Salvatore (University of Messina)
Carvalho, Davide (Universidade do Porto)
Salazar, Daniela Alves (Universidade do Porto)
Christ, Emanuel (University Hospital Basel (Basilea, Suïssa))
Debono, Miguel (Sheffield Teaching Hospitals NHS Foundation Trust (Sheffield, Regne Unit))
Dusek, Tina (University Hospital Center Zagreb)
García-Centeno, Rogelio (Hospital General Universitario Gregorio Marañón)
Ghigo, Ezio (University of Turin)
Gasco, Valentina (University of Turin)
Góth, Miklós I. (Hungarian Defense Forces)
Olah, Dóra (Hungarian Defense Forces)
Kovacs, Laszlo (Hungarian Defense Forces)
Høybye, Charlotte (Karolinska University Hospital and Karolinska Institutet (Suècia))
Kocjan, Tomaz (Univerza V Ljubljani)
Kozamernik, Katarina Mlekuš (Univerza V Ljubljani)
Kužma, Martin (University Hospital Bratislava)
Payer, Juraj (University Hospital Bratislava)
Medić Stojanoska, Milica (University of Novi Sad)
Novak, Anela (University Hospital Center Split)
Miličević, Tanja (University Hospital Center Split)
Pekic, Sandra (University of Belgrade)
Milijic, Dragana (University of Belgrade)
Pérez Luis, Jesus (Universidad de La Laguna)
Picó Alfonso, Antonio M (Centro de Investigación Biomédica en Red de Enfermedades Raras)
Preda, Veronica (Macquarie University)
Raverot, Gérald (Hôpital Louis Pradel)
Borson-Chazot, Francoise (Hôpital Louis Pradel)
Rochira, Vincenzo (Azienda Ospedaliero-Universitaria di Modena. Ospedale Civile di Baggiovara)
Monzani, Maria Laura (Azienda Ospedaliero-Universitaria di Modena. Ospedale Civile di Baggiovara)
Sandahl, Kristian (Aarhus University Hospital (Aarhus, Dinamarca))
Tsagarakis, Stylianos (Evangelismos General Hospital)
Mitravela, Vana (Evangelismos General Hospital)
Zacharieva, Sabina (Medical University - Sofia)
Zilatiene, Birute (Lithuanian University of Health Sciences)
Verkauskiene, Rasa (Lithuanian University of Health Sciences)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	Guidelines recommend adults with pituitary disease in whom GH therapy is contemplated, to be tested for GH deficiency (AGHD); however, clinical practice is not uniform. Aims: (1) To record current practice of AGHD management throughout Europe and benchmark it against guidelines; (2) To evaluate educational status of healthcare professionals about AGHD. Design: Online survey in endocrine centres throughout Europe. Patients and methods: Endocrinologists voluntarily completed an electronic questionnaire regarding AGHD patients diagnosed or treated in 2017-2018. Results: Twenty-eight centres from 17 European countries participated, including 2139 AGHD patients, 28% of childhood-onset GHD. Aetiology was most frequently non-functioning pituitary adenoma (26%), craniopharyngioma (13%) and genetic/congenital midline malformations (13%). Diagnosis of GHD was confirmed by a stimulation test in 52% (GHRH+arginine: 45%; insulin-tolerance: 42%, glucagon: 6%; GHRH alone and clonidine tests: 7%); in the remaining, ≥3 pituitary deficiencies and low serum IGF-I were diagnostic. Initial GH dose was lower in older patients, but only women <26 years were prescribed a higher dose than men; dose titration was based on normal serum IGF-I, tolerance and side-effects. In one country, AGHD treatment was not approved. Full public reimbursement was not available in four countries and only in childhood-onset GHD in another. AGHD awareness was low among non-endocrine professionals and healthcare administrators. Postgraduate AGHD curriculum training deserves being improved. Conclusion: Despite guideline recommendations, GH replacement in AGHD is still not available or reimbursed in all European countries. Knowledge among professionals and health administrators needs improvement to optimise the care of adults with GHD.
Nota:	Altres ajuts: Pfizer, Independent Grant for Learning & Change (IGLC) ID 9939445.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	European journal of endocrinology, Vol. 184 Núm. 2 (2021) , p. 323-334, ISSN 1479-683X

DOI: 10.1530/EJE-20-1180
PMID: 33320830

12 p, 1.3 MB

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