Patients with adult growth hormone deficiency (AGHD) who receive early and sustained growth hormone replacement (GHR) therapy are likely to benefit from improved quality of life and reduced disease-related economic burden, but studies have yet to examine the direct cost or caregiver burden of the disease, according to a recent literature review published in Current Medical Research and Opinion.
“Despite a wealth of information on the efficacy and safety of treatments for GHD, only a small number of studies reported on the humanistic and economic burden, and none reported data on the direct costs or caregiver burden of the disease—making it difficult to build a full and accurate picture of the impact of AGHD,” Jane Loftus, from Pfizer Ltd in Surrey, United Kingdom, and colleagues wrote in their review.
Burden is broad, poorly studied
Although the researchers found significant evidence of the positive impact of regular treatment for individuals with AGHD, they noted there were only 14 studies between January 2006 and July 2016 that met inclusion criteria of studying the humanistic and economic burden of AGHD. Of these, 7 studies were 5-years-old, and no study had looked at the economic burden associated with AGHD since 2014.
Seven studies used the Quality of Life-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) instrument, which measured health-related QoL (HR-QoL) outcomes such as cognitive function, emotional functioning, social functioning, motivation, sleep, and physical impact. In 4 studies, HR-QoL was significantly impaired in AGHD patients at baseline compared with the general population as measured by QoL-AGHDA scores and 5 studies showed worse HR-QoL in women compared with men.
Energy, vitality most consistently impaired
The negative impact on HR-QoL of untreated AGHD was underscored in 2 of the studies reviewed. Researchers found memory and concentration domains are most impaired, followed by tiredness, self-confidence, tenseness, and socialization issues. In one study, 91% of AGHD patients reported energy and vitality were the domains most consistently affected, and other patients frequently reported symptoms of anxiety, social isolation, and depressed mood.