A positive effect of GH treatment on CVD and fracture risk could be concluded , but study design limitations have to be considered .
Stroke and secondary brain tumours remained more prevalent .
Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment .
All fatal and nonfatal malignancies were not more prevalent in  GH-treated adults compared to the general population .
Due to the positive effects demonstrated in r and omized clinical trials on cardiovascular surrogate markers and bone metabolism , a positive effect of growth hormone ( GH ) treatment on clinical ly relevant end-points seems feasible .
In this review , we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency ( GHD ) with emphasis on morbidity : fatal and nonfatal cardiovascular disease ( CVD ) and stroke , fractures , fatal and nonfatal malignancies and recurrences , and diabetes mellitus .
Adult mortality or morbidity is not increased in childhood-onset growth hormone deficient patients who received pediatric GH treatment: an analysis of the Hypopituitary Control and Complications Study (HypoCCS)
Abstract Background The French Safety and Appropriateness of Growth Hormone treatments in Europe ( SAGhE ) cohort has raised concern of increased mortality risk during follow-up into adulthood in certain patients who had received growth hormone ( GH ) treatment during childhood . The Hypopituitary Control and Complications Study monitored mortality and morbidity of adult GH-deficient patients including those with childhood-onset GH deficiency ( COGHD ) who received GH treatment as children . Purpose Evaluate risk of mortality , cancer , myocardial infa rct ion ( MI ) and stroke in a prospect i ve observational study . Methods COGHD patients [ n = 1,204 , including 389 diagnosed with idiopathic COGHD ( ICOGHD ) ] had received pediatric GH treatment .  St and ardized mortality ratios ( SMRs ) , and cancer st and ardized incidence ratios ( SIRs ) in patients without a prior cancer were estimated relative to reference population s. Crude incidence rates were estimated for MI and stroke . Results No increased mortality or cancer incidence was observed , as compared with reference population s , during a follow-up of 3.7 ± 3.3 years ( mean ± SD ) . The overall SMR for COGHD was 1.14 [ 95 % confidence interval ( CI ) 0.55–2.10 ] , and for ICOGHD , 0.33 ( 0.01–1.84 ) . The overall cancer SIR for COGHD was 0.27 ( 0.01–1.50 ) , and for ICOGHD , 0.00 ( 0.00–2.45 ) . No incident case of MI was reported . The crude stroke incidence rate [ 181.3 per 100,000 person-years ] in COGHD patients was consistent with the rates reported in reference population s. No incident case of stroke was identified in ICOGHD patients who are presumed to have no increased stroke risk factors . Conclusions The results indicate no increased risk of mortality or incidence of cancer , stroke , or MI in adult GH-deficient patients who had previously received pediatric GH treatment
A positive effect of GH treatment on CVD and fracture risk could be concluded , but study design limitations have to be considered .
Stroke and secondary brain tumours remained more prevalent .
Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment .
All fatal and nonfatal malignancies were not more prevalent in  GH-treated adults compared to the general population .
Due to the positive effects demonstrated in r and omized clinical trials on cardiovascular surrogate markers and bone metabolism , a positive effect of growth hormone ( GH ) treatment on clinical ly relevant end-points seems feasible .
In this review , we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency ( GHD ) with emphasis on morbidity : fatal and nonfatal cardiovascular disease ( CVD ) and stroke , fractures , fatal and nonfatal malignancies and recurrences , and diabetes mellitus .