Long-acting growth hormone: an updated Growth Hormone Research Society consensus statement
European Journal of Endocrinology, vol. 195, pp. R73–R96
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 8000 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 individualized 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 emphasized 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.
Authors 38
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Ludwig-Maximilians-Universität München · LMU Klinikum · Deggendorf Institute of Technology
Affiliation as printed
Deggendorf Institute of Technology, Faculty of Applied Healthcare Sciences , Deggendorf 94469 ,
Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig-Maximilians-Universität , Munich 80336 ,
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Affiliation as printed
Developmental Biology & Medicine, Faculty of Biology, Medicine & Health, University of Manchester , Manchester M13 9PL ,
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New York University · NYU Langone Health
Affiliation as printed
NYU Langone Medical Center, Division of Endocrinology Diabetes and Metabolism , New York, NY 10017 ,
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Affiliation as printed
Department of Endocrinology and Internal Medicine, Aarhus University Hospital , Aarhus 8200 ,
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University of Cincinnati · Cincinnati Children's Hospital Medical Center
Affiliation as printed
Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine , Cincinnati, OH 45229 ,
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Massachusetts General Hospital
Affiliation as printed
Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital , Boston, MA 02114 ,
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Universidade Federal do Paraná
Affiliation as printed
Department of Internal Medicine, Endocrine Division (SEMPR), Federal University of Paraná , Curitiba 80030-110 ,
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Universidade Federal do Paraná
Affiliation as printed
Department of Pediatrics, Federal University of Paraná , Curitiba 80060-900 ,
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Université Paris-Saclay · Inserm · Assistance Publique – Hôpitaux de Paris · Bicêtre Hospital · Physiologie et Physiopathlogie Endocriniennes
Affiliation as printed
Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse (HYPO) , Le Kremlin-Bicêtre 94275 ,
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Affiliation as printed
Collège of Paediatrics, Université Claude Bernard Lyon 1, 5, ch de Montlouis , Saint Genis-Laval 69230 ,
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University of Rome Tor Vergata · Karolinska Institutet · Bambino Gesù Children's Hospital
Affiliation as printed
Department of Systems Medicine, University of Rome ‘Tor Vergata’ , Rome 00133 ,
Department of Women's and Children's Health, Karolinska Institutet , Stockholm 17177 ,
Endocrinology & Diabetes Unit, ‘Bambino Gesù’ Children's Hospital , Rome 00165 ,
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Oregon Health & Science University
Affiliation as printed
Pituitary Center, Departments of Medicine and Neurological Surgery, Oregon Health & Science University , Portland, OR 97239 ,
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University Hospital Leipzig · Leipzig University
Affiliation as printed
Department of Oncology, University Cancer Center Leipzig, Leipzig University Hospital , Leipzig 04103 ,
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University of Pennsylvania · Children's Hospital of Philadelphia
Affiliation as printed
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104 ,
Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia , Philadelphia, PA 19104 ,
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UNSW Sydney · St Vincent's Hospital Sydney
Affiliation as printed
Sydney Advanced Endocrinology, St. Vincents Hospital and the University of New South Wales , Sydney, NSW 2010 ,
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Stanford Medicine · Stanford University
Affiliation as printed
Department of Medicine, Division of Endocrinology, Metabolism and Gerontology, Stanford University School of Medicine , Stanford, CA 94305 ,
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University of Gothenburg · Sahlgrenska University Hospital
Affiliation as printed
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of Endocrinology, Sahlgrenska University Hospital , Gothenburg 413 45 ,
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Affiliation as printed
Department of Endocrinology and Internal Medicine, Aarhus University Hospital , Aarhus 8200 ,
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University of Copenhagen · Rigshospitalet · Copenhagen University Hospital
Affiliation as printed
Department of Clinical Medicine, University of Copenhagen , Copenhagen 2200 ,
Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet , Copenhagen 2100 ,
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RWTH Aachen University · Universitätsklinikum Aachen
Affiliation as printed
Division of Endocrinology and Diabetes, RWTH Aachen University Hospital , Aachen 52074 ,
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Charles University · University Hospital in Motol · Fakultní nemocnice Motol a Homolka
Affiliation as printed
Department of Pediatrics, 2nd Faculty of Medicine, Charles University, University Hospital Motol and Homolka , Prague 15006 ,
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Huazhong University of Science and Technology · Tongji Hospital
Affiliation as printed
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030 ,
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Istituto Giannina Gaslini · University of Genoa
Affiliation as printed
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa , Genoa 16147 ,
Department of Pediatrics, Endocrine Unit, Istituto Giannina Gaslini, IRCCS , Genoa 16147 ,
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Affiliation as printed
Rocky Mountain Pediatric Endocrinology , Centennial, CO 80112 ,
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Affiliation as printed
Division of Endocrinology, Department of Pediatrics, University of Minnesota Medical School, M Health Fairview Masonic Children's Hospital , Minneapolis, MN 55454 ,
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Erasmus MC · Erasmus University Rotterdam
Affiliation as printed
Department of Internal Medicine, Section Endocrinology, and Pituitary Center Rotterdam, Erasmus University Medical Center , Rotterdam 3015 GD ,
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Assistance Publique – Hôpitaux de Paris · Université Paris Cité · Hôpital Necker-Enfants Malades
Affiliation as printed
Service d’Endocrinologie, Gynécologie et Diabétologie Pédiatriques, Hôpital Universitaire Necker Enfants Malades Paris, Université Paris Cité, Assistance Publique-Hôpitaux de Paris , Paris 75015 ,
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Affiliation as printed
The Southwest Center for the Advancement of Clinical and Translational Science Innovation, The University of Arizona Health Sciences , Tucson, AZ 85724 ,
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Karolinska Institutet · Karolinska University Hospital
Affiliation as printed
Department of Women´s and Children's Health, Karolinska Institutet and Karolinska University Hospital , Stockholm SE-17177 ,
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Ludwig-Maximilians-Universität München · LMU Klinikum
Affiliation as printed
Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig-Maximilians-Universität , Munich 80336 ,
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Universidade do Estado do Rio de Janeiro
Affiliation as printed
Department of Internal Medicine, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20550-170 ,
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University of Manchester · St Mary's Hospital
Affiliation as printed
Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, St. Mary's Hospital , Manchester M139WL ,
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Charité - Universitätsmedizin Berlin
Affiliation as printed
Dept. of Endocrinology and Metabolism, Charité Universitaetsmedizin Berlin Campus Mitte , Berlin 10117 ,
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Radboud University Medical Center · Radboud University Nijmegen
Affiliation as printed
Radboud University Medical Center, Department of Internal Medicine, Division of Endocrinology , Radboud University, Nijmegen 6525 GA ,
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Affiliation as printed
Department of Human Molecular Genetics and Biochemistry, Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv 6139001 ,
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Friedrich-Alexander-Universität Erlangen-Nürnberg · Universitätsklinikum Erlangen
Affiliation as printed
Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) , Erlangen-Nuremberg, Erlangen 91054 ,
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University of Arizona · Barrow Neurological Institute · Creighton University · University of Arizona College of Medicine- Phoenix
Affiliation as printed
Barrow Pituitary Center, Barrow Neurological Institute, Departments of Neuroendocrinology and Neurosurgery, University of Arizona College of Medicine and Creighton University School of Medicine , Phoenix, AZ 85013 ,
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Martin Bidlingmaier corresponding
Ludwig-Maximilians-Universität München · LMU Klinikum
Affiliation as printed
Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig-Maximilians-Universität , Munich 80336 ,
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