Growth hormone therapy –
growth hormone, growth hormone indications
Growth hormone therapy for short stature: Importance of first-year response
Growth hormone therapy for short stature: Importance of first-year response
Should idiopathic short stature (ISS) treated?
ISS is severe short stature without a known cause, and includes children with short parents.
Being short has psychosocial implications and it is estimated that approximately 80 percent of all children referred for short stature, at the end of the diagnostic work−up, will be labeled as ISS. [J Pediatr 1994;125:29-35]
Short stature is referred to as having a height for age below the third percentile or below 2.5 percent to 3 percent of normal children. The number of children being treated for ISS in Hong Kong is very low. The cost of therapy and the fear of injections often deter patients.
Growth hormone indications
Long-term r-hGH therapy can lead to increased adult height in children with ISS. Growth hormone therapy is indicated for the treatment of ISS, defined by height standard deviation score (SDS) ≤−2.25, and associated with growth rates unlikely to permit attainment of adult height in the normal range, in pediatric patients whose epiphyses are not closed and for whom diagnostic evaluation excludes other causes associated with short stature that should be observed or treated by other means. [Arch Pediatr Adolesc Med 2004;158:108-110]
A randomized, placebo-controlled trial reported that a mean duration of 4.4 years of r-hGH treatment (0.2 mg/kg per week administered three times weekly) increased adult height outcomes by a mean of 3.7 cm. [J Clin Endocrinol Metab 2004;89:3140-3148]
Another study showed that use of a higher dosage of daily r-hGH (0.37 vs 0.24 mg/kg per week) increased the mean difference between measured and predicted adult height from 5.4 to 7.2 cm.[J Pediatr 2005;146:45-53]
The benefit of growth hormone therapy was confirmed in a review of trials on the impact of growth hormone treatment on adult height of children with ISS. The average adult height achieved by treated children exceeded that of untreated controls, from 0.57 to 0.70 SD score (3.4-4.2 cm). [BMJ 2011;342:c7157]
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