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Optimizing growth hormone therapy in children

A Grimberg1, P Cohen

  • 1Division of Pediatric Endocrinology, Children's Hospital of Philadelphia and the University of Pennsylvania, USA.

Hormone Research
|January 1, 1997
PubMed
Summary
This summary is machine-generated.

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Recombinant human growth hormone (rhGH) is a safe therapy, but optimizing its use requires identifying ideal patients, determining optimal dosing and timing, and establishing clear treatment endpoints for better growth outcomes.

Area of Science:

  • Endocrinology
  • Pediatric Growth Disorders
  • Pharmacology

Background:

  • Recombinant human growth hormone (rhGH) has been used for over 12 years as a safe and effective therapeutic agent.
  • Despite its established use, optimizing rhGH therapy requires addressing several key issues for improved patient outcomes and future research.

Purpose of the Study:

  • To review and identify critical areas for optimizing recombinant human growth hormone (rhGH) therapy.
  • To guide future research by highlighting unresolved questions in rhGH treatment protocols.

Main Methods:

  • Literature review of existing data on rhGH therapy in pediatric and adult populations.
  • Analysis of approved indications, treatment parameters, and adverse effects associated with rhGH.

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Main Results:

  • Approved pediatric indications include GH deficiency, chronic renal insufficiency, and Turner syndrome; long-term benefits for other conditions require further demonstration.
  • Daily subcutaneous injections at bedtime are suggested as superior to thrice-weekly or morning dosing.
  • Growth response appears dose-dependent in children (0.025-0.1 mg/kg/day) and effective at lower doses in adults.

Conclusions:

  • Further research is needed to define optimal patient selection, treatment initiation/cessation criteria, and precise dosing for rhGH therapy.
  • Both auxologic and biochemical markers are useful for assessing efficacy, but individualized dose adjustments may benefit from monitoring GH-dependent growth factors.