Clinical Advances in Adult Growth Hormone Deficiency: Delivering Patient Care To Improve Outcomes

Clinical Advances in Adult Growth Hormone Deficiency
1.0 AMA PRA Category 1 Credit(s)
Launch Date:
August 06, 2019
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Endocrinologists, endocrinology fellows, PCPs, PAs, NPs, and other healthcare providers.

Relevant Terms:

Growth hormone deficiency, Adult growth hormone deficiency, Recombinant human growth hormone therapy

Beverly M K Biller, MD (Chairperson)

Professor of Medicine
Harvard Medical School
Neuroendocrine Unit
Massachusetts General Hospital
Boston, Massachusetts

Dr Beverly MK Biller is an endocrinologist in the Massachusetts General Hospital (MGH) Neuroendocrine Clinical Center.  She is a faculty member in the Neuroendocrine Unit at MGH and a Professor of Medicine at Harvard Medical School.  Dr Biller's major clinical and research interests include the diagnosis and treatment of Cushing's disease, prolactinomas, acromegaly, other pituitary tumors and sellar masses, and pituitary hormone deficiencies in adults.

Jose Manuel Garcia, MD, PhD

Associate Professor, Department of Medicine
Division of Gerontology and Geriatric Medicine
University of Washington School of Medicine
Clinician Investigator
Geriatric Research, Education and Clinical Center
VA Puget Sound Health Care System
Seattle, Washington

Dr Jose Manual Garcia is an Associate Professor in the Department of Medicine, Division of Gerontology and Geriatric Medicine at the University of Washington School of Medicine in Seattle, Washington. He is also a Clinician Investigator at the Geriatric Research, Education and Clinical Center at the VA Puget Sound Health Care System.

Dr Garcia completed his doctorate Baylor College of Medicine in Houston, Texas and his fellowship in diabetes, endocrinology, and metabolism at Baylor College of Medicine/MD Anderson Cancer Center. He completed his residency in internal medicine at George Washington University in Washington, DC and medical school at the Universidad Catolica de Cordoba in Cordoba, Argentina.

His current research focuses on the role of ghrelin, androgens, and other anabolic pathways in different wasting conditions including aging and cachexia. His basic lab is focused on understanding molecular pathways involved in the development of muscle wasting, fat atrophy, and anorexia in these settings, and in the development of novel targets for these conditions. His group is also involved in several human trials in patients with cancer anorexia and cachexia aiming at characterizing the pathways involved and identifying the mechanisms of action of different potential therapies. He has also recently begun a program to study hormonal deficiencies in the setting of traumatic brain injury.

Gudmundur Johannsson, MD, PhD

Professor of Endocrinology
Institute of Medicine
Sahlgrenska Academy, University of Gothenburg
Senior Consultant
Department of Endocrinology
Sahlgrenska University Hospital
Göteborg, Sweden

Dr Gudmundur Johannsson is a Professor of Endocrinology and Vice-Prefect at the Institute of Medicine, Sahlgrenska Academy, at the University of Gothenburg in Göteborg, Sweden. He is also a Senior Consultant in the Department of Endocrinology at Sahlgrenska University Hospital in Göteborg, Sweden.

Dr Johannsson’s primary research interests include pituitary diseases, the importance of growth hormone in adults, and adrenal insufficiency. He is a board member (president elect) of the Growth Hormone Research Society Council, and actively supports a number of journals. He is the Editor of the European Journal of Endocrinology and has served on the Editorial Board of the Journal of Clinical Endocrinology and Metabolism, and Growth Hormone & IGF Research. Dr Johannsson has more than 200 publications in peer-reviewed journals.

1. IDENTIFY key clinical components, including recent advances, that inform the diagnosis of GHD in adult patients. 
2. EVALUATE the clinical necessity, efficacy, and safety of rhGH therapy as a treatment strategy for adult GHD.
3. RECOMMEND individualized dosing and monitoring strategies for adults using growth hormone therapy.
4. INCORPORATE practical strategies to address barriers to rhGH therapy adherence and improve the delivery of patient centered-care for adult patients with GHD.

Supported by an educational grant from Novo Nordisk Inc.

The diagnosis of growth hormone deficiency (GHD) in adults can be difficult, not only due to the complex nature of the disease itself, but also the absence of specific pathognomonic features. Although treatment with recombinant human growth hormone (rhGH) has demonstrated a long history of clinical efficacy and safety in the management of patients with GHD, a multitude of clinical obstacles can contribute to poor outcomes, including missed or delayed diagnoses, substandard treatment strategies, and/or suboptimal patient adherence. Fortunately, a number of recent advances in the diagnosis and management of patients with GHD, including innovations in rhGH delivery and the continued development of long-acting rhGH formulations, have the potential to help clinicians and patients overcome many of these management challenges.

This online, interactive activity offers a unique approach to patient-centered medical education. The program features several international experts on growth hormone deficiency providing not only evidence-based information on adult GHD diagnosis, treatment, and barriers to adherence, but also important expert discussions and in-depth case analyses to illustrate the concepts.

The goal of this activity is to provide endocrinology and primary care healthcare providers (physicians, NPs, PAs), as well as other healthcare providers involved in the management of adult patients with GHD, with the most up-to-date information on the diagnosis, management, and treatment options for adult GHD and strategies to overcome barriers to adherence.

This activity is intended for endocrinologists and endocrine fellows, primary care physicians, physicians assistants, nurse practitioners, and other healthcare professionals.

The Endocrine Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Endocrine Society has achieved Accreditation with Commendation.

The Endocrine Society designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™ and 1.0 ABIM.MOC Point. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC point in the American Board of Internal Medicines (ABIM) Maintenance of Certification (MOC) program. It is the CME activity providers responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

As an accredited provider of Continuing Medical Education (CME) by the Accreditation Council for Continuing Medical Education (ACCME), the Endocrine Society is also able to provide Maintenance of Certification (MOC) points through the ABIM MOC Assessment Recognition Program. As such, the Endocrine Society ensures that activities registered by the Society for ABIM MOC recognition meet the requirements for all MOC activities as defined by the American Board of Internal Medicine (ABIM). The Endocrine Society is responsibility for submitting participant completion information to ACCME for the purpose of granting ABIM MOC credit.

For questions about content or obtaining CME credit, please contact the Endocrine Society at

As a provider of continuing medical education (CME) accredited by the Accreditation Council for Continuing Medical Education, the Endocrine Society has a policy of ensuring that the content and quality of this educational activity are balanced, independent, objective, and scientifically rigorous. The scientific content of this activity was developed under the supervision of the Endocrine Society's Special Programs Committee (SPC). The commercial supporter(s) of this activity have no influence over the planning of this CME activity.

The faculty, committee members, and staff who are in position to control the content of this activity are required to disclose to the Endocrine Society and to learners any relevant financial relationship(s) of the individual or spouse/partner that have occurred within the last 12 months with any commercial interest(s) whose products or services are related to the CME content. Financial relationships are defined by remuneration in any amount from the commercial interest(s) in the form of grants; research support; consulting fees; salary; ownership interest (eg, stocks, stock options, or ownership interest excluding diversified mutual funds); honoraria or other payments for participation in speakers' bureaus, advisory boards, or boards of directors; or other financial benefits. The intent of this disclosure is not to prevent CME planners with relevant financial relationships from planning or delivery of content, but rather to provide learners with information that allows them to make their own judgments of whether these financial relationships may have influenced the educational activity with regard to exposition or conclusion.

The Endocrine Society has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.

The faculty reported the following relevant financial relationship(s) during the content development process for this activity:

Beverly M K Biller, MD: Consulting, Merck, Novo Nordisk, Strongbridge, Pfizer, Aeterna Zentaris; Research Investigator, Novo Nordisk, OPKO

Gudmundur Johannsson, MD, PhD: Board member and innovator: Trophea

Jose Manuel Garcia, MD, PhD: Research Support, Aeterna Zentaris, Pfizer

The following SPC member who planned and reviewed content for this activity reported no relevant financial relationships: Neena Natt, MD

The following SPC members reported relevant financial relationship(s):

Andrew Ahmann, MD: Research Support, Dexcom, Medtronic; Consultant, Dexcom, Eli Lilly & Company, Horizon CME, MannKind, Novo Nordisk, Sanofi; Speaker, Horizon CME; Principle Investigator, National Institute of Health, T1D Exchange, Trial Net

Giuseppe Barbesino, MD: Advisory Boards, Horizon Pharmaceuticals, Ipsen Pharmaceuticals; Spouse, employee of Genzyme

Joan Han, MD: Research Support, Rhythm Pharmaceuticals; Principle Investigator, Insys Therapeutics, Rhythm Pharmaceuticals

Steven T. Harris, MD: Ad hoc consultant on Advisory Boards, Eli Lilly & Company, Radius Health; Speaker, Amgen, Eli Lilly & Company, Radius Health

Jonathan Purnell, MD: Advisor, Novo Nordisk

Neda Rasouli, MD: Research Support, Novo Nordisk, Boehringer Ingelheim, Rhythm Pharmaceuticals, Elira Therapeutics; Consultant, Intarcia

Amy Rothberg, MD: Spouse, Consultant of Merck

Susmeeta Sharma, MD: Speaker, Corcept

The Endocrine Society has reviewed these relationships to determine which are relevant to the content of this activity and resolved any identified conflicts of interest for these individuals.

The following SPC members reported no relevant financial relationships:

Beret Ann Casey, MD; Lorena Alarcon-Casas Wright, MD, Deborah Sellmeyer, MD

The information presented in this activity represents the opinion of the faculty and is not necessarily the official position of the Endocrine Society.

Use of Professional Judgment:
The educational content in this activity relates to basic principles of diagnosis and therapy and does not substitute for individual patient assessment based on the health care providers examination of the patient and consideration of laboratory data and other factors unique to the patient. Standards in medicine change as new data become available.

Drugs and Dosages:
When prescribing medications, the physician is advised to check the product information sheet accompanying each drug to verify conditions of use and to identify any changes in drug dosage schedule or contraindications.

The Endocrine Society has determined that disclosure of unlabeled/off-label or investigational use of commercial product(s) is informative for audiences and therefore requires this information to be disclosed to the learners at the beginning of the presentation. Uses of specific therapeutic agents, devices, and other products discussed in this educational activity may not be the same as those indicated in product labeling approved by the Food and Drug Administration (FDA). The Endocrine Society requires that any discussions of such “off-label” use be based on scientific research that conforms to generally accepted standards of experimental design, data collection, and data analysis. Before recommending or prescribing any therapeutic agent or device, learners should review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse events.

The Endocrine Society will record learner's personal information as provided on CME evaluations to allow for issuance and tracking of CME certificates. The Endocrine Society may also track aggregate responses to questions in activities and evaluations and use these data to inform the ongoing evaluation and improvement of its CME program. No individual performance data or any other personal information collected from evaluations will be shared with third parties.

Instructions for Participation and Credit
This enduring activity is presented in an online recorded session format. The estimated time to complete this activity, including review of material, is 1.0 hour. To receive a maximum of 1.0 AMA PRA Category 1 Credit™ participants must complete the activity evaluation, as well as a(n) answer sheet or posttest achieving a minimum score of 70%. If learners do not achieve a passing score of 70%, they have the option to retake the posttest.



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