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High-dose growth hormone (GH) treatment in prepubertal GH-deficient children
S Yokoya1, K Araki, Y Igarashi
1Department of Pediatrics, Toranomon Hospital, Tokyo, Japan.
Insights
Higher doses of growth hormone (GH) significantly increased height velocity in growth hormone-deficient boys during the first year. Optimized GH dosing protocols effectively improved growth rates and height SDS without advancing bone maturation.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Growth hormone (GH) deficiency impacts prepubertal growth in children.
- Optimizing GH dosage is crucial for sustained treatment efficacy and managing the 'waning' effect.
Purpose of the Study:
- To evaluate the impact of different growth hormone (GH) doses on prepubertal growth in GH-deficient boys.
- To compare the efficacy of novel GH dosing regimens against conventional doses.
Main Methods:
- Two clinical studies were conducted involving GH-deficient boys.
- Study 1 compared fixed doses (1.0 and 1.5 IU/kg/week) against a conventional dose (0.5 IU/kg/week).
- Study 2 employed a variable dosing strategy over four years (0.5, 0.75, 1.0, then 0.5 IU/kg/week).
Main Results:
- A dose-dependent increase in height velocity was observed in the first year of treatment.
- Variable and higher fixed GH doses led to significantly greater growth rates compared to controls.
- No adverse advancement in bone maturation was noted across the different treatment protocols.
Conclusions:
- Optimized growth hormone (GH) dosing protocols can effectively enhance prepubertal height gain in children with GH deficiency.
- These regimens demonstrate potential for sustained treatment effect and improved outcomes.
- The findings support the use of tailored GH therapy to maximize growth potential.
Abstract:
Two clinical studies were conducted to determine the effect of different doses of growth hormone (GH) on prepubertal growth in GH-deficient boys. In one study, GH doses of 1.0 and 1.5 IU/kg/week (0.33 and 0.5 mg/kg/week) were given to groups of five children and compared with a conventional Japanese dose of 0.5 IU/kg/week (0.17 mg/kg/week) in 15 children. A significant dose-dependent increase in height velocity occurred in the first year of treatment, but differences between doses were not significant thereafter. In a second study, GH was administered to ten boys at a dose of 0.5 IU/kg/week for the first year, 0.75 IU/kg/week for the second year, 1.0 IU/kg/week for the third year and 0.5 IU/kg/week for the fourth and subsequent years (0.17, 0.25, 0.33 and 0.17 mg/kg/week, respectively). During the second and third years of GH treatment, these boys had significantly higher growth rates than controls, who were given GH at 0.5 IU/kg/week (0.17 mg/kg/week) throughout, indicating successful reduction in 'waning' of the treatment effect. At the end of the fourth year, the different protocols from the two studies had both resulted in a greater height SDS than the controls, and did not advance bone maturation. In conclusion, these protocols may be effective in increasing prepubertal height gain in children with GH deficiency.