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Use of growth hormone-gel
Insights
Growth hormone (GH) depot gel offers physiological plasma concentrations and may reduce injection frequency. However, this novel preparation does not solve the waning growth response observed in long-term treatment.
Area of Science:
- Pediatric endocrinology
- Pharmacology
Background:
- Growth hormone (GH) deficiency requires long-term treatment.
- Standard GH preparations involve frequent injections.
- Optimizing GH delivery aims to improve treatment efficacy and patient compliance.
Purpose of the Study:
- To evaluate the efficacy of a novel depot preparation of growth hormone (GH-gel).
- To determine if GH-gel reduces injection frequency and hormone dosage.
- To assess the long-term impact of GH-gel on growth response, particularly the waning effect.
Main Methods:
- A study involving 15 children with growth hormone deficiency.
- Administration of a 15% gelatin solution of GH (GH-gel).
- Comparison of GH-gel pharmacokinetics and growth response against standard aqueous GH preparations.
Main Results:
- GH-gel achieved lower, more physiological plasma GH concentrations post-administration.
- GH-gel given twice weekly showed growth response comparable to thrice-weekly aqueous GH.
- A decreased growth rate during the second year of treatment was observed with both GH-gel and aqueous preparations.
- Weight-adjusted dosing of GH-gel in the second year did not resolve the waning growth response.
Conclusions:
- GH-gel provides more physiological GH plasma levels, potentially reducing hormone quantity and injection frequency.
- The depot preparation does not overcome the long-term waning response to growth hormone therapy.
- Further research is needed to address the diminished efficacy over extended treatment periods.
Abstract:
We evaluated the efficacy of a depot preparation of growth hormone (GH) in a 15% gelatin solution (GH-gel) in the treatment of 15 growth hormone-deficient children. The studies were designed to see if prolonging absorption of GH to achieve lower more physiological concentrations of GH in plasma would decrease the frequency of injection, reduce the amount of GH needed for effective therapeutic response, and improve the response to long-term treatment. We found that after a single dose of GH-gel the plasma concentrations of GH were lower than those achieved after the standard aqueous preparation. The preparation was efficacious in promoting growth and our 1st study of 6 patients suggested that GH-gel given twice a week had a growth response equal to that of the three-times a week aqueous schedule. However both schedules resulted in the frequently observed decreased growth rate during the second treatment year. Our 2nd study, attempting to ameliorate this waning effect by using the GH-gel preparation twice a week in a weight-adjusted dose during the entire second year did not resolve the problem. Thus, GH in depot gel results in more physiological plasma concentrations of GH and may be beneficial in reducing the quantity of hormone needed and the injection frequency but it does not offer a solution to the waning response to the long-term administration of GH.