Human GH Use By Athletes With Short Stature Without GH Deficiency: Therapeutic Use Exemptions

Area of Science:

• Sports Medicine
• Endocrinology
• Medical Ethics

Background:

• Organized sports rely on rules for fair play, with doping posing a significant challenge.
• The World Anti-Doping Agency (WADA) maintains a List of Prohibited Substances and Methods to combat doping.
• Athletes with medical conditions may require exemptions (Therapeutic Use Exemptions - TUEs) for prohibited treatments.

Purpose of the Study:

• To develop guidelines for Therapeutic Use Exemptions (TUEs) for human growth hormone (hGH) in adolescent athletes with short stature.
• To differentiate between medically necessary hGH therapy and performance enhancement in non-GH-deficient athletes.

Main Methods:

• Expert consensus on the medical necessity of hGH treatment for short stature in adolescent athletes.
• Establishing criteria for granting TUEs based on growth curves and adult height percentiles.

Main Results:

• hGH treatment for non-GH-deficient short stature athletes can be considered therapeutic if they are below 2.25 SD on the growth curve.
• A TUE for hGH is permissible until the athlete reaches the 5th percentile of adult normal height.
• Beyond this threshold, hGH treatment is deemed not medically necessary, and TUEs should be denied.

Conclusions:

• Guidelines are established to determine the medical necessity of hGH treatment for adolescent athletes with short stature.
• These guidelines aim to ensure fair play while accommodating legitimate medical needs.
• The criteria focus on growth parameters to differentiate therapeutic use from enhancement.