Somatropin (Growth hormone) (Various (lowest cost preparation)) – Adults: Profound growth hormone deficiency

NICE recommendations, summary of meeting discussions, links to additional supporting docs etc.

(See also  Red and Double Red sections for use in children)

NICE Guidance (August 2003): Somatropin should be used in adults only if the following three criteria are fulfilled:

* Severe growth deficiency, established by an appropriate method (peak GH response of < 9mU/litre (3ng/ml) during an insulin tolerance test (cross-validated GH threshold in an equivalent test).

* Impaired quality of life, measured by means of a specific questionnaire.

* Already receiving treatment for another pituitary hormone deficiency.

Somatropin treatment should be discontinued if the quality of life has not improved sufficiently by 9 months.

Severe growth hormone deficiency developing after linear growth is complete but before the age of 25 years should be treated with growth hormone; treatment should continue until adult peak bone mass has been achieved. Treatment for adult-onset growth hormone deficiency should be stopped only when the patient and the physician consider it appropriate.

Treatment with somatropin should be initiated and managed by a physician with expertise in growth hormone disorders; maintenance treatment can be prescribed in the community under a shared-care protocol.

In November 2004 the TAG confirmed that until such time as an agreed Shared Care Protocol is available, prescribing of growth hormone in adults will remain as Hospital Only.