Patients with growth hormone deficiency secondary to an intracranial lesion should be examined frequently for progression or recurrence of the underlying disease process. Somatrem should be discontinued if there is evidence of recurrent tumor activity. Concomitant glucocorticoid therapy may inhibit the growth promoting effect of somatrem. Patients with coexisting ACTH deficiency should have their glucocorticoid replacement dose carefully adjusted to avoid an inhibitory effect on growth. Hypothyroidism may develop during somatrem treatment.
Untreated hypothyroidism prevents optimal response to somatrem.
Therefore, patients should have periodic thyroid function tests and should be treated with thyroid hormone when indicated. Leukemia has been reported in a small number of growth hormone deficient patients, treated with growth hormone. On the basis of current evidence, experts cannot conclude that growth hormone therapy is responsible for these occurrences. If there is any risk to an individual patient, it is small. Symptoms usually occurred within the first 8 weeks of the initiation of growth hormone therapy.