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Long-term results with growth hormone therapy in idiopathic hypopituitarism
S Bernasconi1, T Arrigo, M Wasniewsk
1Department of Paediatrics, Universities of Modena and Reggio Emilia, Messina, Italy. berna@unimo.it
Insights
Early growth hormone (GH) treatment in children with GH deficiency, especially within the first five years of life, can lead to achieving target adult height. This suggests early and continuous GH replacement therapy is crucial for optimal growth outcomes.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Child Development
Background:
- Growth hormone (GH) deficiency treatment in children is established but often yields unsatisfactory long-term height outcomes.
- The efficacy of recombinant human GH (rhGH) therapy has been documented for over three decades.
- Factors influencing treatment success, such as timing and duration, require further investigation.
Purpose of the Study:
- To evaluate the long-term efficacy of early-initiated recombinant GH therapy in GH-deficient children.
- To determine the impact of early treatment initiation on achieving target adult height.
- To identify key variables influencing growth response to GH therapy.
Main Methods:
- Retrospective analysis of GH-deficient children treated with daily recombinant GH injections.
- Treatment initiated within the first five years of life.
- Assessment of adult height relative to target height, considering factors like birth weight and pubertal onset.
Main Results:
- Children treated with daily recombinant GH within the first five years of life achieved adult heights close to their target height.
- Early initiation and continuous therapy until adulthood were associated with successful catch-up growth.
- Birth weight significantly influenced growth response, highlighting the role of fetal growth.
Conclusions:
- Early initiation of GH replacement therapy (before age 5) and continuation until adulthood are critical for achieving target height in GH-deficient children.
- Birth weight is a significant predictor of growth response, emphasizing the importance of fetal development.
- Optimizing GH therapy requires consideration of treatment timing, duration, and individual growth factors.
Abstract:
More than 30 years after its introduction, growth hormone (GH) treatment is well established in children with GH deficiency. Nevertheless, the long-term results of this therapy, expressed as height, are generally considered unsatisfactory. We report on results obtained in a group of GH-deficient children who were treated with daily injections of recombinant GH within the first 5 years of life and who reached an adult height very close to their target height. The full catch-up growth to the target height demonstrated in these patients suggests that replacement therapy should be started early and continued until adulthood. Height at onset of puberty is an important variable which might significantly influence the adult height. The significant and prolonged influence of birth weight on growth response to GH therapy underlines the important role of fetal growth in planning early treatment of GH-deficient children.