In research examining the effects of growth hormone therapy in patients with a growth hormone deficiency, researchers initially used recombinant growth hormone replacement therapy for a total duration of four years. This was found to increase bone mineral density by the rate of 1% per year in the participants.
The factors that were found to predict the benefits of growth hormone replacement therapy were a below-average bone mass prior to replacement therapy and the gender of the participant. However, sustainment of the benefits observed with growth hormone replacement therapy has not yet been proven. Additionally, the requirement of using drugs such as alendronate with anti-resorptive functions in growth hormone deficient patients has also not been established but theoretically, the use of such drugs should have positive beneficial effects when administered in conjunction with HGH injections to patients with growth hormone deficiency.
Research On Combined Therapy with HGH and Alendronate
Participants: 30 participants with established growth hormone deficiency were selected for the study. The participants were divided into two groups based on their bone mineral density, 15 participants with osteoporosis, and 15 participants with low bone mass. All of the 30 participants received replacement therapy with recombinant growth hormone for a minimum duration of 4 years. After the completion of the 4 years of therapy with recombinant growth hormone, the participants with osteoporosis received an additional 3 years of alendronate drug therapy while the participants with low bone mineral density received continued therapy with growth hormone. In each participant, the dose of growth hormone was altered based on his or her IGF-1 levels. The IGF-1 levels were titred to normal ranges and were independent of the gender of the participant.
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Results: After completion of the initial part of the study i.e. 4 years replacement therapy with growth hormone, all participants were found to have a significant rise in the bone mineral density of their lumbar spine. There was very little difference in the results of the therapy between the two groups, with a 3.6% rise in BMD in the osteoporotic group and a 7.0 % rise in BMD in the second group. The study reported a slight difference in the increase in bone mineral density in males compared to females. In the participants who received alendronate at doses of 10 mg per day, BMD of lumbar spine increased by 8.7% in stark contrast to the 1.5% rise in BMD in the second group who did not receive alendronate therapy. The effect of alendronate therapy was found to be independent of gender. During the 7-year study period, there were no changes in the average bone surface area. Bone mineral density of the femoral bone’s neck in the participants with osteoporosis increased by 3.5 %. Prior to starting the therapy with alendronate, five of the osteoporotic participants had a total of 12 fractures in their vertebral column. After initiation of alendronate therapy, only one patient presented with new fractures after one year of therapy.
What Do The Study Findings Mean?
The study reported a significant rise in bone mineral density within the first 4 years of recombinant growth hormone therapy. Additionally, the efficacy of growth hormone replacement therapy was found to be dependent on the gender of the participant but not on the previous BMD of the participants. After the initial 4 years of replacement therapy, there was no significant change in the results and the increase in BMD had plateaued after 3-4 years of treatment with growth hormone therapy alone. However, in patients receiving alendronate, the rise in BMD was significant in comparison to those participants who did not receive alendronate. All participants exhibited a lowered incidence of vertebral fractures corresponding to the observed rise in BMD. The study reports prove the beneficial effects of combined therapy with growth hormone replacement and alendronate in patients with osteoporosis.