Growth Hormone vs Heart Failure

There's been a lot of ruckus lately about illicit use of performance enhancing drugs in professional baseball again.  Chief among the popular drugs are various forms of testosterone, an anabolic steroid, meaning it helps build up, as opposed to catabolic, which means to break down.  In the background lurks growth hormone, a significantly more expensive non-steroid hormone, originally used to help vertically-challenged kids get closer to predicted adult height, but now purportedly used by the anti-aging set, especially in Hollywood, to maintain the veil of youth.  Concern has been expressed about its use in professional football, as well.

But as with most things in life, there's more grey than there is black & white.  In a randomized controlled single-blind study published in this month's JACC Heart Failure, the authors concluded that growth hormone (GH) was of benefit to those chronic heart failure (CHF) patients with GH deficiency (GHD).  Granted, this was a small study in which only 31 CHG+GHD patients completed the 4yr trial which was a follow up to a 6mo trial published September 2009 in Journal of Clinical Endocrinology & Metabolism.  

I found the methodology interesting in that 0.012mg/kg was injected every other day, rather than the daily protocols typically used at about half that dose.  Regardless, this wasn't an inexpensive endeavor.  More importantly, all participants had laboratory proven GHD, having failed a stimulation test, as opposed to declaration based upon single IGF-1 (insulin-like growth factor 1) measurement.  But if this medication is proven safe & effective in large multicenter trials of a randomized, placebo-controlled, double-blind fashion (review of 12 small studies demonstrated similar benefit in January 2007 JCEM), we just might see another drug added to our arsenal for optimal medical management of chronic heart failure.

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