Growth hormone by daily injection in patients previously treated for growth hormone deficiency

When recombinant-DNA-derived methionyl growth hormone (met-GH) became available for patients resuming treatment, we were able to compare dose intervals in 47 prepubertal children with growth hormone deficiency. Patients were randomly assigned to one or three doses weekly or to daily injections for a total dosage of 0.3 mg/kg weekly. If the patient's annual growth failed to increase more than 2 cm above baseline, the dose interval was changed from weekly to three times a week or from three times a week to daily. In the second year of the study, all patients received daily injections. Despite a mean duration of previous treatment with growth hormone of more than 3 years, daily injections in 16 patients throughout the first year of the study resulted in a mean growth velocity (9.6 +/- 2.4 cm) comparable to that in newly treated patients given met-GH three times weekly in other trials. Administration by daily injection was more effective than injection three times per week (P less than .05) in 13 patients (7.9 +/- 2.1 cm) or once a week in four patients (7.7 +/- 1.2 cm). Second year growth velocities in 21 patients who had received once-a-week or three-times-a-week injections the first year of the study, increased significantly with a change to daily injection (7.7 +/- 2.2 vs 8.8 +/- 1.9 cm) (P less than .05).