IGF1 and nutritional deficiency disease: One of the main limitations of the studies presented in this review, in addition to the considerable heterogeneity, is the varying impact of rhGH and anti-cytokine therapy, which can be influenced by important factors such as the dosage and duration of GC therapy, the level of inflammatory cytokines, baseline GH-IGF1 values, the malnutrition and metabolic status, and the different levels of disease activity (remission, mild, moderate, severe).