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Recombinant human growth hormone in short children born small for gestational age. German Study Group
1Department of Paediatrics, Dr. von Haunersches Kinderspital, Munich, Germany.
Insights
Recombinant human growth hormone (rhGH) therapy effectively promotes linear growth and catch-up growth in short children born small for gestational age (SGA). Daily rhGH injections at 0.1-0.2 IU/kg for 24 months demonstrated safety and significant height velocity increases.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Hormone Therapy
Background:
- Children born small for gestational age (SGA) often experience persistent short stature.
- Growth hormone (GH) deficiency is not always the cause of short stature in SGA children.
- Recombinant human growth hormone (rhGH) is a potential therapeutic option for improving growth in these children.
Purpose of the Study:
- To evaluate the efficacy and safety of rhGH treatment in prepubertal, non-GH deficient children born SGA.
- To compare the effects of two different rhGH dosages (0.1 IU/kg and 0.2 IU/kg) on growth parameters.
- To assess the impact of rhGH on height velocity, bone age, and catch-up growth over a 2-year period.
Main Methods:
- A randomized controlled trial involving 69 prepubertal children born SGA with short stature.
- Children were allocated to three groups: no treatment, daily subcutaneous rhGH at 0.1 IU/kg, or 0.2 IU/kg.
- Growth parameters, including height velocity and bone age, were monitored over 24 months.
Main Results:
- rhGH treatment significantly increased height velocity SDS compared to the control group.
- Higher rhGH dosage (0.2 IU/kg) showed a greater initial increase in height velocity SDS in the first year.
- Catch-up growth was achieved in a high percentage of treated children (86-95% in year 1, 65-79% in year 2).
- rhGH treatment accelerated bone age, with good treatment tolerance and no significant laboratory abnormalities.
Conclusions:
- Daily rhGH administration (0.1-0.2 IU/kg/day) for 24 months is an effective and safe therapy for increasing linear growth in short SGA children.
- The treatment successfully induces catch-up growth in this population.
- The findings support rhGH as a viable therapeutic strategy for managing short stature in SGA children without GH deficiency.
Abstract:
The effects of recombinant human growth hormone (rhGH) treatment in 69 prepubertal, non-GH deficient children born small for gestational age (SGA) were evaluated over 2 years. At start of the study mean age was 5.1 years, mean bone age was 3.8 years and mean height SDS was -4.0. The children were randomly allocated to 3 groups receiving no treatment or daily subcutaneous injections of rhGH at a dose of 0.1 IU/kg body weight (group 0.1 IU) or 0.2 IU/kg body weight (group 0.2 IU). At start of the study mean height velocity SDS was -1.4 in the control group, -0.7 in group 0.1 IU and -1.4 in group 0.2 IU. After 2 years there was a significant increase in height velocity SDS in children treated with rhGH as compared to untreated children. Mean height velocity SDS after the first year of treatment was -1.2 in the control group, 2.8 in group 0.1 IU and 5.5 in group 0.2 IU. Corresponding values during the second year were -0.9, 1.6 and 2.9. A statistically significant difference was observed between the groups receiving 0.1 IU/kg/day and 0.2 IU/kg/day during the first year of treatment, whereas no difference between the treatment groups was found during the second year. Catch-up growth, i.e. a height velocity 1 SD above the mean, was achieved for 86% of group 0.1 IU and 95% of group 0.2 IU during the first year of treatment and was maintained for 65% and 79% of the patients in group 0.1 IU and 0.2 IU respectively in the second year. GH treatment was associated with a distinct acceleration of bone age. Tolerance of treatment was good. No clear trends were seen in any of the laboratory variables. In conclusion, this study shows that daily rhGH given at a dose of 0.1-0.2 IU/kg/day for 24 months is an effective and safe therapy to increase linear growth and induce catch-up growth in short SGA children.