Individualizing growth hormone dosing in children.

Area of Science:

• Pediatric Endocrinology
• Growth Hormone Therapy
• Biochemical Monitoring

Background:

• Decades of research have advanced growth hormone (GH) management in children and adolescents.
• Current GH therapy helps most children achieve normal final height, but optimal outcomes are not universal.
• Variability in individual response necessitates personalized treatment approaches.

Purpose of the Study:

• To review current understanding and emerging strategies in growth hormone (GH) therapy management for children and adolescents.
• To highlight the importance of individualized treatment plans and monitoring approaches.
• To discuss the evolving role of biochemical markers in optimizing GH therapy.

Main Methods:

• Review of established and emerging practices in pediatric growth hormone (GH) therapy.
• Emphasis on auxological monitoring, including height velocity and height z-score changes.
• Discussion of biochemical monitoring, focusing on serum insulin-like growth factor (IGF)-I and IGF binding protein-3.

Main Results:

• Height velocity and interval height increase remain key parameters for monitoring GH treatment response.
• Routine monitoring of serum IGF-I and IGF binding protein-3 is an emerging standard for safety and compliance.
• IGF monitoring shows potential for assessing and optimizing GH therapy response through dose adjustment.

Conclusions:

• Individualizing GH therapy is increasingly recognized as essential due to significant inter-patient variability.
• Biochemical and auxological monitoring are established approaches for assessing GH treatment.
• Future optimization strategies, including prediction modeling and IGF-guided dose titration, are under investigation to refine individualized GH dosing.