GH therapy can increase short-term growth and improve ( near ) final height .
Increases in height are such that treated individuals remain relatively short when compared with peers of normal stature .
BACKGROUND Idiopathic short stature ( ISS ) refers to children who are very short compared with their peers for unknown or hereditary reasons .
Recombinant human growth hormone ( GH ) has been used to increase growth and final height in children with ISS .
OBJECTIVES To assess the effects of recombinant human GH on short-term growth and final height in children with ISS .
High dose growth hormone treatment induces acceleration of skeletal maturation and an earlier onset of puberty in children with idiopathic short stature
Background : Long term growth hormone ( GH ) treatment in children with idiopathic short stature ( ISS ) results in a relatively small mean gain in final height of 3–9 cm , which may not justify the cost of treatment . As it is unknown whether GH treatment during puberty adds to final height gain , we sought to improve the cost – benefit ratio , employing a study design with high dose GH treatment restricted to the prepubertal period . Aims : To assess the effect of short term , high dose GH treatment before puberty on growth , bone maturation , and pubertal onset . Methods : Five year results of a r and omised controlled study are reported . Twenty six boys and nine girls were r and omly assigned to a GH treatment group ( n = 17 ) or a control group ( n = 18 ) . Inclusion criteria were : no signs of puberty , height less than −2 SDS , age 4–8 years for girls or 4–10 years for boys , GH concentration > 10 μg/l after provocation , and normal body proportions . To assess GH responsiveness , children assigned to the GH treatment group received GH treatment for two periods of three months ( 1.5 IU/m2/day and 3.0 IU/m2/day ) , separated by three month washout periods , during the first year of study . High dose GH treatment ( 6.0 IU/m2/day ) was then started and continued for at least two full years . When puberty occurred , GH treatment was discontinued at the end of a complete year ’s treatment ( for example , three or four years of GH treatment ) . Results : In response to at least two years on high dose GH treatment , mean ( SD ) height SDS for chronological age increased significantly in GH treated children from −2.6 ( 0.5 ) to −1.3 ( 0.5 ) after two years and −1.4 ( 0.5 ) SDS after five years of study . No changes in height SDS were observed in controls . A rapid rate of bone maturation of 3.6 years/2 years in treated children compared to 2 years/2 years in controls was observed in response to two years high dose GH treatment . Height SDS for bone age was not significantly different between groups during the study period . GH treated children entered into puberty at a significantly earlier age compared to controls . Conclusions : High dose GH treatment before puberty accelerates bone age and induces an earlier onset of puberty . This may limit the potential therapeutic benefit of this regimen in ISS
GH therapy can increase short-term growth and improve ( near ) final height .
Increases in height are such that treated individuals remain relatively short when compared with peers of normal stature .
BACKGROUND Idiopathic short stature ( ISS ) refers to children who are very short compared with their peers for unknown or hereditary reasons .
Recombinant human growth hormone ( GH ) has been used to increase growth and final height in children with ISS .
OBJECTIVES To assess the effects of recombinant human GH on short-term growth and final height in children with ISS .