Long-acting growth hormone: An updated Growth Hormone Research Society consensus statement

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.

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Publication Details

Journal
European Journal of Endocrinology
Published
2026-09-01
DOI
https://doi.org/10.1093/ejendo/lvag167
Primary Topic
Growth Hormone and Insulin-like Growth Factors
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article
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article

Long-acting growth hormone: An updated Growth Hormone Research Society consensus statement

Nidhi Agrawal, Haim Werner, Andrew R. Hoffman, Sally Radovick et al.
European Journal of Endocrinology
Growth Hormone and Insulin-like Growth Factors
article

Long-acting growth hormone: An updated Growth Hormone Research Society consensus statement

Nidhi Agrawal, Haim Werner, Andrew R. Hoffman, Sally Radovick, Bradley S. Miller, Jan Lebl, Mohamad Maghnie, Margaret Cristina da Silva Boguszewski, Sebastian Neggers, Júnia Ribeiro de Oliveira Longo Schweizer, Mai Christiansen Arlien-Søborg, Philippe Chanson, Xiaoping Luo, Judith Gebauer, Peter Clayton, Lars Sävendahl, Maria Fleseriu, Anders Juul, Christian J. Strasburger, Ken K. Y. Ho, Gudmundur Johannsson, Adda Grimberg, Martin Bidlingmaier, César Luiz Boguszewski, Christa C. van Bunderen, Stefano Cianfarani, Beverly M. K. Biller, Michel Polak, Aristides K Maniatis, Joachim Woelfle, Katharina Schilbach, Jens Otto Lunde Jørgensen, Philippe Backeljauw, Adam Stevens, Paulo Ferrez Collett‐Solberg, Wolfram Karges, Pierre Chatelain, Kevin C J Yuen
article en

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.

European Journal of Endocrinology
Université Claude Bernard Lyon 1 (FR), University of Rome Tor Vergata (IT), University of Copenhagen (DK), Rocky Mountain Institute (US), Cincinnati Children's Hospital Medical Center (US), Hôpital Necker-Enfants Malades (FR), University of Minnesota (US), Fairview Health Services (US), Barrow Neurological Institute (US), Karolinska University Hospital (SE), Children's Hospital of Philadelphia (US), Radboud University Nijmegen (NL), Inserm (FR), Tel Aviv University (IL), Oregon Health & Science University (US), Friedrich-Alexander-Universität Erlangen-Nürnberg (DE), Université Paris Cité (FR), Charles University (CZ), Université Paris-Saclay (FR), Manchester Academic Health Science Centre (GB), Arizona Science Center (US), Sahlgrenska University Hospital (SE), Istituto Giannina Gaslini (IT), Erasmus MC (NL), Aarhus University Hospital (DK), Copenhagen University Hospital (DK), Rigshospitalet (DK), Radboud University Medical Center (NL), Karolinska Institutet (SE), University of Manchester (GB), Neuroendocrine Tumor Research Foundation (US), LMU Klinikum (DE), Universidade do Estado do Rio de Janeiro (BR), NYU Langone Health (US), St Vincent's Hospital Sydney (AU), St Mary's Hospital (GB), Massachusetts General Hospital (US), Universitätsklinikum Erlangen (DE), University Hospital in Motol (CZ), St Vincent’s Private Hospital Sydney (AU), Bambino Gesù Children's Hospital (IT), University Hospital Leipzig (DE), Stanford Medicine (US), Neurological Surgery (US), Tongji Hospital (CN), Bicêtre Hospital (FR), Huazhong University of Science and Technology (CN), Universidade Federal do Paraná (BR), Charité - Universitätsmedizin Berlin (DE), University of Pennsylvania (US), Ludwig-Maximilians-Universität München (DE), Deggendorf Institute of Technology (DE), University of Genoa (IT), RWTH Aachen University (DE), Erasmus University Rotterdam (NL), Stanford University (US)
Pfizer, AstraZeneca, Sanofi, Massachusetts General Hospital, Novo Nordisk, Université Paris-Saclay, Assistance publique-Hôpitaux de Paris, Ipsen
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Growth Hormone and Insulin-like Growth Factors
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