Meta-analysis indicates increased BMI SD scores with long-acting growth hormone versus daily rhGH in children

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The Journal of clinical endocrinology and metabolism Published April 22, 2026 Medically reviewed May 25, 2026 Study authors: Levaillant Lucie, Bouhours-Nouet Natacha, Emeriau Fabienne, Donzeau Aurelie, Rouleau Stéphanie, Vill… PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Note the association between LAGH use and increased BMI SD scores in the first year, with safety data not reported.

This meta-analysis synthesized data from 585 children with growth hormone deficiency comparing long-acting growth hormone (LAGH) to daily rhGH treatment. The primary outcome focused on body mass index (BMI) SD scores over a follow-up period of 6.0 months, with abstract data available at 12 and 24 months.

At 12 months, a significant difference in BMI SD scores was observed between groups, with an effect size of 0.66 SDS and a 95% CI 0.04-1.29 indicating an increase in the LAGH group. Change in BMI SDS from 0 to 12 months showed a significant increase in the LAGH group (0.41 SDS; 95% CI 0.04-0.77) versus no change in the daily GH group (-0.35 SDS; 95% CI -0.76 to +0.07).

From 12 to 24 months, a significant increase occurred in the daily GH/LAGH switching group (0.75 SDS; 95% CI 0.24-1.27), while the LAGH/LAGH group remained steady. The authors note an increase in body mass index SD score is associated with the first year of LAGH use.

Longitudinal BMI data were not available for polyethylene glycol LAGH. Safety outcomes, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Clinicians should not assume safety data due to lack of reporting regarding adverse events.

Study Details

Study typeMeta analysis

Sample sizen = 585

EvidenceLevel 1

Follow-up6.0 mo

PublishedApr 2026

PMID41787735

View Original Abstract ↓

BACKGOUND: The purpose of this study is to compare the effect of long-acting growth hormone (LAGH) to daily GH on body mass index (BMI) in children with growth hormone deficiency (GHD). METHODS: We searched the PubMed database from its inception to July 2025 and identified three relevant randomized controlled trials lasting over 6 months, with extension phases providing longitudinal BMI data. Longitudinal BMI data were available for lonapegsomatropin, somatrogon, and somapacitan, but not for polyethylene glycol LAGH. RESULTS: A total of 585 patients were included in the present analysis, of which 346 were in the LAGH group, and 239 were in the daily rhGH group, derived from seven original articles and two abstracts/ePosters. At 12 months, there was a significant difference in BMI SD scores between LAGH and daily GH groups (Mean difference [MD] 0.66 SDS [95% confidence interval [CI] 0.04-1.29]). BMI SDS significantly increased in the LAGH group (MD + 0.41 SDS [95% CI 0.04-0.77] from 0 to 12 months), whereas it did not change in the daily GH group (MD -0.35 SDS [95% CI -0.76 to +0.07] from 0 to 12 months). Between 12 and 24 months, after switching from daily GH to LAGH (daily GH/LAGH), or pursuing LAGH (LAGH/LAGH) in the extension phases of the studies, BMI SDS significantly increased in the daily GH/LAGH switching group (MD + 0.75 SDS [95% CI 0.24-1.27] from 12 to 24 months), whereas it remained steady in the LAGH/LAGH group. Omitting one study at a time from the meta-analysis did not materially affect the results. CONCLUSION: An increase in body mass index SD score is associated with the first year of LAGH use.