Growth Hormone and Treatment Controversy; Long-Term Safety of rGH

The availability of recombinant human growth hormone (rGH) for the treatment of growth disorders has provided an unlimited supply for replacement in patients with growth hormone insufficiency, but also for short stature due to Turner syndrome, renal failure, Prader-Willi syndrome, small for gestational age and idiopathic short stature. Considering the potential for side effects in the use of a growth promoting agent, the community of physicians and pharmaceutical manufacturers developed systematic methods to survey for short- and long-term effects. Recently published data from the National Cooperative Growth Study, managed by Genentech, concluded that GH has a ‘favorable profile’. In 2012, results from the European Union’s Safety and Appropriateness of GH treatment in Europe (EU SAGhE) study about the long-term mortality in GH-treated patients were published in two separate manuscripts. This review will examine the issue of safety of rGH in order to better inform practitioners as they consider initiation of therapy with patients.