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CME: Adult Growth Hormone Deficiency (GHD): Therapeutic Updates, Present Clinical Controversies, and Barriers to Care

Activity Description / Statement of Need:

In this online CME self-learning program:


Growth hormone deficiency (GHD), a condition characterized by inadequate endogenous production. When its onset occurs in adulthood, the etiology is related predominantly to oncologic causes (or their attendant treatment) in the vast majority of cases. In the United States, more than 50,000 adults are estimated to be growth hormone deficient, and 6,000 new cases are reported each year, inclusive of children with GHD who transition to adulthood (the prevalence of pediatric GHD is estimated to be between 1 in 4,000 and 1 in 10,000).


The classification of GHD depends on the underlying pathology and stems from one or more of the following: the inability of the pituitary gland to produce growth hormone (pituitary or classic); the failure of the hypothalamus to produce and/or transmit the messaging hormone growth hormone releasing hormone (GHRH) (hypothalamic GHD); the failure of other hormonal/metabolic functions caused by various or unknown etiologies that lead to pituitary failure to produce, uptake or utilize GH (functional GHD); and when the cause is unknown, it is characterized as idiopathic GHD. With respect to secondary causes, GHD may  result from congenital genetic disorders, tumors, infections, radiation, trauma, psychosocial deprivation, hypothyroidism, poorly controlled diabetes mellitus, hormonal treatments, certain drugs, malnutrition, nutritional malabsorption, or gastrointestinal disorders.




Introduction, disclosures

A review primer: epidemiologic, pathophysiologic, etiologic features, and clinical signs and symptoms

  • Common ground: definitions, background, statistics
  • Leading abnormalities and causes
  • Comorbidities and complications
  • Clinical pearls, diagnostic practice guidance, and missed opportunities in patients presentation

Treatment options available for acromegaly

  • Best practices
  • Pharmacotherapy detailing: review, update, and emerging products
  • Clinical controversies
  • Monitoring parameters, counseling points, barriers to care, and patient education
  • Patient case(s)

Summary, conclusions, and best practice recap

Target Audience:


Healthcare professionals specializing in: endocrinology and those who otherwise commonly care for or clinically encounter adult patients with GHD.

This program is supported by an educational grant from Novo Nordisk.

Release Date: July 12, 2016 -- Expiration Date: July 12, 2018

Faculty: Julie Silverstein, MD


Learning Objectives

By the end of the session the participant will be able to:

  • Summarize present guideline- and evidence-based for the diagnosis of GHD
  • Describe the underlying pathophysiological and typical clinical features of GHD as they pertain to therapeutic targets.
  • Given a patient with GHD, design a pharmacotherapeutic regimen based on his or her clinical presentation.
  • Assess and properly manage the significant comorbidities that are associated with GHD and therefore increase mortality in patients with GHD
  • Evaluate patient cases during follow-up visits in a manner that optimizes one or more of the following: efficacy, safety, quality of life, or patient education and adherence.



Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure: Dr. Julie Silverstein, MD, Assistant Professor of Medicine & Neurological Surgery Medical Director Pituitary Center Washington University School of Medicine has Pfizer, Novartis, and Novo Nordisk financial relationships to disclose.


Disclosures of Educational Planners: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC with no relevent financial disclosures.


Commercial Support Disclosure: This program is supported by an educational grant from Novo Nordisk.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

The Current and Emerging Landscape of Adult Growth Hormone Deficiency (AGHD) Pharmacotherapy

Pediatric Growth Hormone Deficiency (PGHD): Therapeutic Updates, Present Clinical Controversies, and Barriers to Care