Treatment of growth hormone deficiency with long-acting growth hormones in children, adolescents and adults: Clinical evidence and practical considerations - 11/09/26

Doi : 10.1016/j.ando.2026.103093

Agnès Linglart ^a,⁎ , Régis Coutant ^b, Véronique Kerlan ^c, Marc Nicolino ^d, Michel Polak ^e, Gérald Raverot ^f,^g, Patrice Rodien ^h,ⁱ, Thierry Brue ^j,^k

^a Service d’endocrinologie et diabétologie de l’enfant, Centre de référence des maladies rares de l’hypophyse (Filière OSCAR), INSERM U1185, Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Le Kremlin-Bicêtre, France

^b Service d’endocrinologie et diabétologie pédiatrique, Centre de référence des maladies rares de la thyroïde et des récepteurs hormonaux, Centre de référence (constitutif) des maladies rares de l’hypophyse, FIRENDO network, CHU Angers, Angers, France

^c Service d’endocrinologie, diabétologie et maladies métaboliques, Centre Hospitalier Universitaire de Brest, Université Brest, INSERM, UMR 1304 (GETBO), Brest, France

^d Service d’endocrinologie et diabétologie pédiatrique et Centre PRISIS (pathologies rares de l’insulino-sécrétion et de l’insulino-sensibilité), FIRENDO network, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Bron, France

^e Endocrinologie, gynécologie et diabétologie pédiatriques, Hôpital Universitaire Necker Enfants Malades, Institut Imagine, INSERM U1163, Institut Cochin, INSERM U1016, Centre de référence des pathologies endocriniennes rares de la croissance et du developpement, FIRENDO network, Université de Paris Cité, Paris, France

^f Fédération d’endocrinologie, Centre de référence des maladies rares de l’hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France

^g INSERM U1052, Université Claude-Bernard-Lyon-1, Lyon, France

^h Service d’endocrinologie, diabétologie et nutrition, Centre de référence des maladies rares de la thyroïde et des récepteurs hormonaux (TRH), Centre de référence des maladies rares de l’hypophyse (HYPO), FIRENDO network and ENDO-ERN network, CHU d’Angers, Angers, France

ⁱ Institut MITOVASC, Université d’Angers, Angers, France

^j Service d’endocrinologie, Centre de référence des maladies rares de l’hypophyse HYPO, Hôpital de la Conception, AP-HM, Marseille, France

^k Institut national de la santé et de la recherche médicale, INSERM U1251, Marseille medical genetics (MMG), Institut Marseille maladies rares (MarMaRa), Aix-Marseille Université, Marseille, France

^⁎ Corresponding author: Service d'Endocrinologie et Diabète de l'Enfant, AP-HP. Université Paris-Saclay - Hôpital Bicêtre, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France Service d'Endocrinologie et Diabète de l'Enfant, AP-HP. Université Paris-Saclay - Hôpital Bicêtre 78 rue du Général Leclerc Le Kremlin-Bicêtre 94270 France

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Friday 11 September 2026

Highlights

•	Daily injections were long the standard treatment for growth hormone deficiency
•	Once-weekly growth hormone aims to reduce treatment burden
•	Long-acting growth hormones showed similar efficacy and safety to daily products
•	Practical guidance on dosing, monitoring and use in special populations is provided
•	Long-term data are needed to provide further insights into safety and adherence

Le texte complet de cet article est disponible en PDF.

Abstract

Growth hormone deficiency (GHD) is a rare endocrine disorder affecting both children and adults that may occur in isolation or as part of multihormonal hypopituitarism. Recombinant human growth hormone (GH) administered as daily injections has long been the standard of care and improves growth, body composition and quality of life. However, daily administration is associated with a substantial treatment burden and adherence is frequently suboptimal, particularly in children and adolescents.

Long-acting growth hormone (LAGH) formulations have been developed to reduce injection frequency and potentially support long-term adherence. Three once-weekly LAGH products are currently available in the EU: lonapegsomatropin, somatrogon and somapacitan. Clinical trials have demonstrated non-inferiority of LAGHs compared with daily GH in children in terms of annualised height velocity. Safety profiles were consistent with those of daily GH.

This review summarises the clinical evidence for LAGH formulations, including patient preference and the impact on metabolism, bone health and muscle strength. With a focus on somapacitan, currently the only LAGH approved in France for both children and adults, the review discusses practical aspects of dosing and monitoring across age groups and addresses use in special populations and during the transition period from paediatric to adult care. Ongoing follow-up and real-world studies will further clarify long-term safety, adherence and metabolic outcomes.

Le texte complet de cet article est disponible en PDF.

Keywords : Growth hormone deficiency, lonapegsomatropin, long-acting growth hormone, somapacitan, somatrogon, transition of care