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Response to growth hormone in children with idiopathic short stature
Insights
Recombinant somatropin significantly increased growth velocity in children with short stature. Treatment regimens, including frequency and duration, impacted growth outcomes, suggesting potential gains in predicted adult height.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Short stature in children not meeting classic criteria for growth hormone deficiency (GHD) presents a treatment challenge.
- Understanding the efficacy of recombinant human growth hormone (somatropin) in this population is crucial.
Purpose of the Study:
- To evaluate the efficacy of recombinant somatropin in improving growth velocity in children with short stature.
- To compare different treatment regimens, including frequency and duration, of somatropin therapy.
Main Methods:
- A multicentre randomized trial involving 121 children with short stature.
- Treatment with recombinant somatropin (0.1 mg/kg three times weekly) in the first year.
- Comparison of thrice-weekly versus once-daily somatropin administration in the second year.
Main Results:
- Significant increase in mean growth velocity from 4.6 cm/year to 7.5 cm/year in the first year of treatment.
- Untreated children showed no significant change in growth velocity.
- Second-year treatment, both thrice-weekly and once-daily, resulted in mean growth velocities of 8.2 cm/year and 9.0 cm/year, respectively.
Conclusions:
- Recombinant somatropin effectively enhances growth velocity in children with short stature.
- Both thrice-weekly and once-daily somatropin regimens demonstrate efficacy.
- Treatment suggests a gain in predicted adult height, exceeding bone age advancement.
Abstract:
A multicentre randomized trial of human growth hormone (GH) treatment was carried out in 121 children with short stature who did not meet the classic criteria for GH deficiency. In the first year of the trial, half of the children received treatment with recombinant somatropin 0.1 mg/kg (0.27 IU/kg) three times weekly and showed a significant increase in mean growth velocity from a pretreatment value of 4.6 +/- 1.1 to 7.5 +/- 1.2 cm/year (mean +/- SD). The growth velocity of the untreated children did not change significantly. The growth velocity of the control group (including 10 pubertal children) increased from 4.2 +/- 1.3 to 5.0 +/- 1.4 cm/year. In the second year, half of the control group received treatment with somatropin, 0.1 mg/kg (0.27 IU/kg) three times weekly, while the remainder received the same weekly dose on a once-daily basis. The mean growth velocity increased in both cases to 8.2 +/- 1.4 and 9.0 +/- 1.6 cm/year, respectively. The group treated during the first year was also divided into two groups in the second year. One group continued with the original treatment regimen, resulting in a mean growth velocity of 6.8 +/- 1.8 cm/year. The other group changed to once-daily treatment at the same weekly dose and the mean growth velocity for this group in the second year was 7.8 +/- 1.4 cm/year. The gain in height age in both of these groups exceeded the bone age in both the first and second years of treatment, suggesting a gain in predicted adult height.(ABSTRACT TRUNCATED AT 250 WORDS)