Details

Autor(en) / Beteiligte

• Rekers-Mombarg, L.T.M.
• Massa, G.G.
• Wit, J.M.
• Matranga, A.M.C.
• Buckler, J.M.H.
• Butenandt, O.
• Chaussain, J.L.
• Frisch, H.
• Leiberman, E.
• Yturriaga, R.

Titel

Growth hormone therapy with three dosage regimens in children with idiopathic short stature

Ist Teil von

• The Journal of pediatrics, 1998-03, Vol.132 (3), p.455-460

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

1998

Quelle

Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)

Beschreibungen/Notizen

• Objective: In children with idiopathic short stature (ISS) we studied the growth-promoting effect at 4 years of recombinant human growth hormone (rhGH) therapy in three dose regimens and evaluated whether increasing the dosage after the first year could prevent a decline in height velocity (HV). Design: Included were 223 patents who were treated with subcutaneous administrations of rhGH 6 days per week. They were randomized to three groups: 3 IU/m 2 body surface/day, 4.5 IU/m 2/day, and 3 IU/m 2/day during the first year and 4.5 IU/m 2/day thereafter, corresponding with dosages of 0.2 and 0.3 mg/kg body weight/week, respectively. Growth was compared with a standard of 229 untreated children with ISS [ISS standard]. Results: During the first year of treatment HV almost doubled and was higher with 4.5 IU/m 2 than with 3 IU/m 2. In the second year HV no longer differed among the groups, but increasing the dosage slowed the rate of the fall of HV. During 4 years of therapy the height SD score for age increased by a mean (SD) of 2.5 (1.0) [ISS standards], or 1.2 (0.7) (British standards), bone age increased by 4.8 (1.3) years, and predicted adult height SD score increased by 1.5 (0.7). After 4 years the results of the group with 4.5 IU/m 2 were slightly better than those of the other groups. When dropouts were included in the analysis (assuming a stable height SD score after discontinuation of rhGH therapy), height gain was still significant. Conclusions: During 4 years of rhGH therapy, growth and final height prognosis improved, slightly more with 4.5 IU/m 2 than with 3 IU/m 2 or 3 to 4.5 IU/m 2. However, bone age advanced on average 4.8 years during this period; therefore, any effect on final height will probably be modest. (J Pediatr 1998;132:455-60)