ClinicalTrials.gg
RecruitingNCT04867317GRITUpdated Oct 13, 2026

Growth Hormone Replacement Therapy in Veterans With Mild Traumatic Brain Injury (mTBI) and Adult Growth Hormone Deficiency (AGHD)

A Phase 3 interventional study of Somatropin and Placebo in Adult Growth Hormone Deficiency and Mild Traumatic Brain Injury, sponsored by VA Office of Research and Development. Recruiting at 16 sites in United States. Open to participants aged 21 Years to 55 Years. Per ClinicalTrials.gov, last updated 2026-10-13.

Sponsored by VA Office of Research and Development · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Jan 2025; still recruiting 1 year 9 months later.
Updated Oct 13, 2026Site recruiting status changedEligibility revisedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
172
Allocation
Randomized
Ages
21 Years to 55 Years
Sex
All
01

Study summary

The purpose of this study is to determine whether growth hormone replacement therapy (GHRT) is effective versus placebo in the improvement of Quality of Life in patients with adult growth hormone deficiency (AGHD) and mild traumatic brain injury (mTBI).

02

Conditions studied

  • Adult Growth Hormone Deficiency
  • Mild Traumatic Brain Injury
03

In context

Dwarfism, Pituitary

252 studies on the registry are indexed under Dwarfism, Pituitary; 30 are open to participants now.

This study's planned enrollment of 172 is above the median of 60 across 169 interventional studies indexed under Dwarfism, Pituitary.

Browse Dwarfism, Pituitary studies →

Lead sponsor

VA Office of Research and Development is the lead sponsor of 1,771 studies on the registry; 392 are open to participants now.

Of its 213 completed or terminated interventional studies of FDA-regulated products, 185 (87%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Oct 13, 2026. See what changed

Ages eligible
21 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. OEF/OIF/OND Veteran
  2. Score of 18 or more on Combat Experiences sub-scale of Deployment Risk and Resilience Inventory-2 (DRRI-2)
  3. One or more mild traumatic brain injury (mTBI) sustained during military service at least 12 months prior to the screening date, as noted via the CRAFT survey.
  4. Growth hormone (GH) deficiency diagnosed by: macimorelin stimulation test (cut point 5.1 micrograms per liter), or glucagon stimulation test (cut point: 3 micrograms per liter (mcg/L) for up to 25; cut point 1 micrograms per liter for body mass index (BMI) 25 and above) and IGF-I lab values have to be less than or equal to +1 SDS at baseline
  5. Score of 11 or more on QoL-AGHDA
  6. 4-week stability on any psychotropic medications
  7. 3-month stability on all other hormone treatments
  8. Able and willing to provide to participate in this study, and complete study protocol

Exclusion criteria

Exclusion Criteria:

  1. History of moderate or severe traumatic brain injury (TBI)
  2. History of neurologic disorder other than traumatic brain injury with substantial impact on quality of life
  3. History of bipolar disorder, schizophrenia, or other concurrent psychotic disorder
  4. Active suicidal ideation (no plan required) as determined by a score of 2 points or more on the Columbia Suicide Severity Rating Scale (C-SSRS) suicidal ideation rating, or overt suicidal behavior in the past 6 months.
  5. to recombinant human growth hormone (rhGH) therapy
  6. Acute medical illness, active infection, cancer or decompensated chronic medical illness
  7. Evidence of substance use disorder, -other than mild alcohol or cannabis use disorder-, or urine toxicology evidence of the use of an illicit drug (excluding cannabis), in the past 6 months. Nicotine use is allowed.
  8. Score less than or equal to 41 on Trial 2 or Retention Trial of the Test of Memory and Malingering (TOMM).
  9. (BMI) > 40 or body weight > 350 pounds
  10. Pituitary anatomy documented by an MRI using a sella protocol within the last 2 years indicating abnormalities consistent with an etiology other than mild-TBI (i.e.; pituitary mass)
  11. Women who are pregnant or of not on
  12. Current use of the following: growth hormone, estrogen or estrogen-like dietary supplements, progestin, IGF-I, or chronic use in supraphysiologic doses
  13. Currently enrolled in any other interventional study unless prior approval is provided by the study chairs and the study sponsor (Cooperative Studies Program)
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
172 participants (estimated)

Study arms

  • Active comparator
    Growth Hormone Replacement Therapy

    Recombinant Human Growth Hormone

    Drug: Somatropin

  • Placebo comparator
    Placebo

    Placebo

    Other: Placebo

Interventions

  • Participants (n=172) will be randomized in a 1:1 ratio to rhGH (n=86) versus placebo (n=86) for six months, stratified by participating site. Both study participants and the study team will be blinded to treatment assignment. All participants will complete in-clinic follow-ups at Days 14, 40, 65, and 90 (3 months) and at day 180 (6 months). The primary outcome will be the mean difference in QoL-AGHDA scores between treatment arms at 6 months follow-up. Patients will discontinue the study intervention at 6 months, and will be followed-up two weeks subsequent, in order to assure patient safety and wellness, and to ensure maximal facilitation of patient transition back into routine care.

  • OtherPlacebo

    Participants (n=172) will be randomized in a 1:1 ratio to rhGH (n=86) versus placebo (n=86) for six months, stratified by participating site. Both study participants and the study team will be blinded to treatment assignment. All participants will complete in-clinic follow-ups at Days 14, 40, 65, and 90 (3 months) and at day 180 (6 months). The primary outcome will be the mean difference in QoL-AGHDA scores between treatment arms at 6 months follow-up. Patients will discontinue the study intervention at 6 months, and will be followed-up two weeks subsequent, in order to assure patient safety and wellness, and to ensure maximal facilitation of patient transition back into routine care.

06

What researchers measure

Primary outcomes

  1. QoL-AGHDA (Quality of Life-Assessment of Adult Growth Hormone in Adults)

    25 question survey on quality of life; The primary objective of CSP #2018 is to determine the efficacy of rhGH, given daily for 6 months, versus placebo to improve QoL, as measured by difference in mean QoL-AGHDA score, among Veterans with a history of mTBI and AGHD (primary outcome). The primary hypothesis is that the investigators, compared to placebo, patients treated with rhGH will exhibit a 3.5-point lower mean score (higher quality of life) in QoL-AGHDA at 6 months. QoL-AGHDA: minimum score=0 (high QoL: best outcome); maximum score=25 (low QoL: worst outcome).

    Time frame: 6 months

Secondary outcomes

  1. Body Composition

    DEXA (Dual-Energy x-ray absorptiometry); The secondary objective of CSP #2018 is to investigate the efficacy of rhGH vs placebo on long-term surrogate outcomes: a) body composition, assessed through dual-energy x-ray absorptiometry (DEXA) and b) cardiometabolic risk factors including lipids, autonomic function, and highly sensitive C-reactive protein. The specific hypotheses for these outcomes are that compared to placebo there will be a 4.5% mean reduction in total truncal body fat percentage and a mean reduction of 10 mg/dL in LDL serum levels after 6 months of treatment and follow-up of rhGH.

    Time frame: 6 months

Other outcomes

  1. Depressive and Anxiety Symptoms measured by Depression Anxiety and Stress Scale (DASS-21)

    Tertiary endpoint of interest: Depressive and anxiety symptoms measured by DASS-21 scores and post-traumatic stress symptoms measured by the PTSD Checklist for DSM-5 are expected to be lower (improved) within the rhGH arm after 6 months of therapy compared to the placebo arm.

    Time frame: 6 months

  2. Cognition

    Tertiary endpoint of interest: Cognitive functioning will be assessed the Color Word Interference Test for cognitive flexibility and inhibition; the Digit Span test for working memory capacity; the Trail Making Test for processing speed, cognitive flexibility, and attention; the Grooved Pegboard for fine motor control and coordination; the Letter Fluency Test for verbal fluency and executive function; and the Rey Auditory Verbal Learning Test for verbal learning, memory, and attention. All test scores will be converted to z-scores, which standardize the results based on the mean and standard deviation of the normative sample, then averaged to generate a composite score, with higher scores indicating better performance relative to the normative sample. Both, individual test scores and the composite score will be analyzed to evaluate whether six-month recombinant human Growth Hormone treatment has any significant effect on cognitive performance.

    Time frame: 6 months

  3. Severity of Fatigue Symptoms

    Tertiary endpoint of interest: Severity of fatigue symptoms measured by the Patient Health Questionnaire 15-item somatic symptom severity scale PHQ-15 are expected to improve after 6 months of rhGH therapy compared to the placebo arm.

    Time frame: 6 months

  4. Sleep Quality

    Exploratory objective and hypothesis: Sleep quality as measured by the Pittsburgh Sleep Quality Index Score (PSQI). The investigators hypothesize that subjective measures of sleep quality and daytime sleepiness will significantly improve in the active arm compared to placebo.

    Time frame: 6 months

  5. Chronic Pain Assessment

    Exploratory objective and hypothesis: Chronic pain assessed using the Defense Veterans Pain Report System-II (DVPRS-II); hypothesize that pain severity and pain interference with activities of daily living will be significantly reduced among participants receiving GHRT compared to placebo.

    Time frame: 6 months

07

Study locations

5 of 16 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — Digital data underlying primary scientific publications from this study will be held as part of a data sharing resource maintained by the Cooperative Studies Program (VA-CSP). These data may be available to the public and other VA and non-VA researchers under certain conditions and consistent with the informed consent and CSP policy which prioritize protecting subjects' privacy and confidentiality to the fullest extent possible.

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jan 2025 (actual). Primary completion is estimated for Feb 2027, 25 months after the start.

Of 19 phase 3 interventional studies under Dwarfism, Pituitary, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 18 and three quarters within 30. This study's planned 25 months is close to that.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 8, 2021
First posted
Apr 30, 2021
StartActual
Jan 13, 2025
Primary completionEst.
Feb 28, 2027
CompletionEst.
Sep 30, 2029
Last update
Oct 13, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Sites
2 sites changed recruiting status (2 now recruiting)
Show 2 sites
  • Rocky Mountain Regional VA Medical Center, Aurora, CO · Aurora, United StatesNot yet recruiting→Recruiting
  • VA Ann Arbor Healthcare System, Ann Arbor, MI · Ann Arbor, United StatesNot yet recruiting→Recruiting
Oct 13, 2026
Eligibility
2 inclusion criteria edited, 1 removed; 4 exclusion criteria edited
What changed in the criteria
Inclusion criteria
  • RemovedAge 21 - 55 years old
  • EditedOne or more mild traumatic brain injury (mTBI) sustained during military service at least 12 months prior to the screening date, as noted via the CRAFT survey.
  • EditedGrowth hormone (GH) deficiency diagnosed by: macimorelin stimulation test (cut point 5.1 mcg/Lmicrograms per liter), or glucagon stimulation test (cut point: 3 micrograms per liter (mcg/L) for BMIbody mass index up to 25; cut point 1 mcg/Lmicrograms per liter for body mass index (BMI) 25 and above) and IGF-I lab values have to be less than or equal to +1 SDS at baseline
Exclusion criteria
  • EditedHistory of moderate or severe traumatic brain injury (TBI)
  • EditedHistory of neurologic disorder other than TBItraumatic brain injury with substantial impact on quality of life
  • EditedContraindication to recombinant human growth hormone (rhGH) therapy
  • Editedbody mass index (BMI) > 40 or body weight > 350 lbspounds
Oct 13, 2026
Secondary outcomes
1 description edited
What changed in the outcomes
  • Descriptionother outcomeSleep Quality: how it is measured was reworded
Oct 13, 2026
Show all 1 update
  1. Oct 13, 2026
    2 sites changed recruiting status (2 now recruiting)
    Show 2 sites
    • Rocky Mountain Regional VA Medical Center, Aurora, CO · Aurora, United StatesNot yet recruiting→Recruiting
    • VA Ann Arbor Healthcare System, Ann Arbor, MI · Ann Arbor, United StatesNot yet recruiting→Recruiting
    Eligibility 2 inclusion criteria edited, 1 removed; 4 exclusion criteria edited
    What changed in the criteria
    Inclusion criteria
    • RemovedAge 21 - 55 years old
    • EditedOne or more mild traumatic brain injury (mTBI) sustained during military service at least 12 months prior to the screening date, as noted via the CRAFT survey.
    • EditedGrowth hormone (GH) deficiency diagnosed by: macimorelin stimulation test (cut point 5.1 mcg/Lmicrograms per liter), or glucagon stimulation test (cut point: 3 micrograms per liter (mcg/L) for BMIbody mass index up to 25; cut point 1 mcg/Lmicrograms per liter for body mass index (BMI) 25 and above) and IGF-I lab values have to be less than or equal to +1 SDS at baseline
    Exclusion criteria
    • EditedHistory of moderate or severe traumatic brain injury (TBI)
    • EditedHistory of neurologic disorder other than TBItraumatic brain injury with substantial impact on quality of life
    • EditedContraindication to recombinant human growth hormone (rhGH) therapy
    • Editedbody mass index (BMI) > 40 or body weight > 350 lbspounds
    Secondary outcomes 1 description edited
    What changed in the outcomes
    • Descriptionother outcomeSleep Quality: how it is measured was reworded
    + 3 other changes: identifiers, verification date and contact details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT04867317
Responsible party
Sponsor
First posted
Apr 30, 2021
Start date
Jan 13, 2025
Primary completion
Feb 28, 2027 (estimated)
Completion
Sep 30, 2029 (estimated)
Last update
Oct 13, 2026

Study contacts

Deane V Walker, MHA BS AB
Contact
Deane.Walker@va.gov
(203) 937-3440 ext. 3787
Michael T Wininger, PhD
Contact
michael.wininger@va.gov
(203) 932-5711 ext. 3262
Jose M. Garcia, MD PhD
study chair · VA Puget Sound Health Care System Seattle Division, Seattle, WA

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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