This SR highlights the lack of long-term RCTs reporting final height data and other important qualitative outcomes , such as quality of life .
ABSTRACT Genotropin ( somatropin ) is licensed for the treatment of children with growth hormone deficiency , Prader-Willi syndrome , Turner syndrome , chronic renal insufficiency and in children born small for gestational age .
This systematic review ( SR ) evaluated the clinical efficacy and effectiveness of Genotropin in these conditions to inform a NICE Technology Appraisal of growth hormone for the treatment of growth failure in children .
Early treatment with GH alone in Turner syndrome: prepubertal catch-up growth and waning effect.
OBJECTIVE In order to ascertain the advantages of early GH treatment in Turner syndrome ( TS ) , we started a prospect i ve study aim ed at evaluating prepubertal height gain in a cohort of 29 girls who were treated with the same pro-kilo GH dose ( 1.0 IU/kg per week ) since they were less than 6 years old and for at least 5 years before entering puberty . PATIENTS AND DESIGN Following a minimum of 6 months of baseline observations , 29 girls with TS were enrolled for this prospect i ve study provided that they ( a ) were less than 6 years old , ( b ) were below -1.0 st and ard deviation score ( SDS ) for height , ( c ) had a projected adult height ( PAH ) lower than the respective target height ( TH ) and ( d ) had a height velocity ( HV ) lower than -1.0 SDS . All the selected girls underwent a 5-year treatment with biosynthetic GH at a stable dose of 1.0 IU/kg per week and were periodically measured during the treatment period in order to evaluate height , HV and PAH . RESULTS After a dramatic acceleration during the 1st year , HV was attenuated during the subsequent years , reaching its nadir at the 5th year . Height deficiency under therapy progressively decreased from entry onwards , shifting from -2.4+/-0.7 to -1.0+/-1.2 SDS . In the same period , mean PAH progressively increased , although after 5 years it remained lower than the average TH . CONCLUSIONS ( a ) An effective growth-promoting strategy in TS should be based on early GH treatment , as suggested by our results . ( b ) This strategy could result in a prepubertal normalization of height , thus allowing the appropriate timing for the induction of puberty . ( c ) An initial GH dose of 1.0 IU/kg per week may be suitable during the first years of therapy , as shown by our data documenting an important waning effect of GH therapy only after the 4th year of treatment . ( d ) No acceleration of bone maturation was observed under this treatment regimen
This SR highlights the lack of long-term RCTs reporting final height data and other important qualitative outcomes , such as quality of life .
ABSTRACT Genotropin ( somatropin ) is licensed for the treatment of children with growth hormone deficiency , Prader-Willi syndrome , Turner syndrome , chronic renal insufficiency and in children born small for gestational age .
This systematic review ( SR ) evaluated the clinical efficacy and effectiveness of Genotropin in these conditions to inform a NICE Technology Appraisal of growth hormone for the treatment of growth failure in children .