GH Dose Reduction Maintains Normal Prepubertal Height Velocity After Initial Catch-Up Growth in Short Children

Area of Science:

• Pediatric Endocrinology
• Growth Hormone Therapy
• Child Development

Background:

• Growth hormone (GH) dosing is guided by responsiveness during catch-up growth (CUG).
• Optimal GH dosing strategies for the prepubertal maintenance treatment period remain unclear.
• Individualized GH dosing based on responsiveness is established for CUG.

Purpose of the Study:

• To assess if a 50% reduced individualized GH dose can maintain channel parallel growth (normal height velocity) post-CUG.
• To evaluate the maintenance of standard deviation score (SDS) channel growth after reducing GH dosage.
• To compare outcomes of reduced individualized GH dose with unchanged individualized and standard fixed doses.

Main Methods:

• Prepubertal children (n=98) with CUG were randomized post-treatment.
• Groups received either a 50% reduced individualized dose (GHRID), unchanged individualized dose (GHUID), or standard fixed dose (GHFIX).
• Primary endpoint was the proportion of children maintaining height SDS within ±0.3 at 1 year.

Main Results:

• 85% of the GHRID group maintained height SDS within ±0.3, significantly higher than GHUID (41%) and GHFIX (48%) groups.
• The GHRID group showed significantly improved IGF-1 SDS levels compared to control groups at 3 months and 1 year.
• Channel parallel growth and IGF-1 SDS within ±2 were maintained with the reduced individualized dose.

Conclusions:

• A 50% reduction in individualized GH dose effectively maintains channel parallel growth post-CUG.
• Individualized GH dosing, even at a reduced level, is effective for prepubertal maintenance treatment.
• This strategy supports normal growth velocity and IGF-1 levels in children after CUG.