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Growth hormone therapy in children: predictive factors and short-term and long-term response criteria

Gabriella Pozzobon1, Cristina Partenope1, Stefano Mora2

  • 1Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Endocrine
|August 20, 2019
PubMed

Insights

Growth hormone (GH) treatment is effective for short children with GH deficiency (GHD), with most reaching mid-parental height. However, defining poor responders remains challenging due to varying criteria and lack of predictive factors.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Childhood Growth Disorders

Background:

  • The definition of growth response in children treated with growth hormone (GH) is debated.
  • Growth hormone deficiency (GHD) affects childhood growth, necessitating effective treatment strategies.

Purpose of the Study:

  • To evaluate the short-term and long-term efficacy of GH treatment in short children with GHD.
  • To compare different criteria for assessing poor growth response to GH therapy.
  • To identify factors that predict growth response in children with GHD.

Main Methods:

  • Ninety-four children with isolated GHD received GH treatment until final height.
  • Poor responder criteria included height gain SDS (Bang, Cianfarani) and height velocity (Bakker, Ranke).
  • Data were analyzed to compare criteria and identify predictive factors.

Main Results:

  • After one year, poor responder rates varied: 55.3% (Bang), 40.9% (Bakker), and 23.4% (Ranke).
  • At final height, 22.34% were poor responders by Cianfarani criteria; 97.9% achieved mid-parental height (MPH).
  • A negative association was found between height gain and age at diagnosis; no reliable predictive factors were identified.

Conclusions:

  • The Bang criterion identified the most poor responders but had low predictive value.
  • Ranke and Cianfarani criteria showed similar poor response rates.
  • Despite challenges in defining poor responders, GH treatment demonstrated good efficacy, with most children achieving their genetic height potential (MPH).
Abstract

Keywords:
Final heightGrowth hormone deficiencyGrowth hormone therapyPoor respondersPredictive factors

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