Skeletal maturity was not accelerated by treatment with recombinant growth hormone ( hGH ) .
BACKGROUND Turner syndrome ( TS ) affects about one in 1500 to 2500 live-born females .
One of the most prevalent and salient features of the syndrome is extremely short stature .
Untreated women are approximately 20 to 21 cm shorter than normal women within their respective population s. Recombinant human growth hormone ( hGH ) has been used to increase growth and final height in girls who have Turner syndrome .
OBJECTIVES To assess the effects of recombinant growth hormone in children and adolescents with TS .
Growth hormone therapy of Turner syndrome: the impact of age of estrogen replacement on final height. Genentech, Inc., Collaborative Study Group.
Clinical trials of recombinant human GH therapy in Turner syndrome that began more than a decade ago show that GH accelerates the linear growth rate . Several studies indicate that final height is also improved , although the magnitude of the increase has been debated . The age at which feminization is induced could be an important factor in determining the patient 's ultimate growth response . To test this , 60 patients from a large ( n = 117 ) , previously unreported , clinical trial of GH treatment were r and omly assigned to begin conjugated estrogens at either 12 or 15 yr of age . The 60 patients were all less than 11 yr of age at entry ( mean , 9.5 yr ) and received 0.375 mg/kg x week of GH for nearly 6 yr on a daily or three times weekly regimen . Height gain was calculated by comparing the study patients ' final or near final heights to their pretreatment projected heights as well as to those of a separate set of age-matched , historical control patients . Patients in whom estrogen treatment was delayed until age 15 yr gained an average of 8.4 + /- 4.3 cm over their projected height , whereas those starting estrogen at 12 yr gained only 5.1 + /- 3.6 cm , on the average ( P < 0.01 ) . Analysis of the interval data showed that growth was stimulated for approximately 2 yr after estrogen initiation , but then declined in association with bone age advancement . Patients who were older than 11 yr at entry ( n = 57 ) all initiated  estrogen  1 yr after beginning GH and showed a mean gain in adult height of 4.7 cm , similar to those given estrogen at age 12 yr . Multivariate analysis revealed that the number of years of GH therapy before estrogen  treatment was a strong factor in predicting height gained , indicating that the timing of estrogen introduction is an important determinant of final height in this cohort of GH-treated patients with Turner syndrome matched for baseline age and other characteristics
Skeletal maturity was not accelerated by treatment with recombinant growth hormone ( hGH ) .
BACKGROUND Turner syndrome ( TS ) affects about one in 1500 to 2500 live-born females .
One of the most prevalent and salient features of the syndrome is extremely short stature .
Untreated women are approximately 20 to 21 cm shorter than normal women within their respective population s. Recombinant human growth hormone ( hGH ) has been used to increase growth and final height in girls who have Turner syndrome .
OBJECTIVES To assess the effects of recombinant growth hormone in children and adolescents with TS .