For height outcome , articles were limited to studies reporting adult height and to systematic review s. FINDINGS Recombinant human growth hormone therapy of children with idiopathic short stature increases height in some children .
The cost-benefit ratio is controversial .
AND RELEVANCE Growth hormone treatment may be considered in some children with idiopathic short stature
IMPORTANCE Approximately 2 % of children are defined as having short stature .
Deciding when to pursue recombinant human growth hormone therapy to increase adult height is controversial .
OBJECTIVE To review the management of children with idiopathic short stature , including diagnostic evaluation and therapeutic options .
Outcome of a four-year randomized study of daily versus three times weekly somatropin treatment in prepubertal naive growth hormone-deficient children. Genentech Study Group.
A comparison was made of the growth responses of prepubertal naive GH-deficient children who were r and omly assigned to receive 0.3 mg/kg.week  recombinant human GH administered either daily ( QD ) or three times weekly ( TIW ) over 4 yr . The effects of the two regimens on annual growth velocity , change in height SD score , bone maturation , and age at onset of puberty are presented as the mean + /- SD . During each of the 4 yr , the annual growth velocity was significantly greater in the QD vs. TIW group . At 48 months , the mean total gain in height was 9.7 cm greater in the QD group ( 38.4 + /- 5.5 ) than that in the TIW group 28.7 + /- 3.2 ; P = 0.0002 ) . The mean height SD score at the end of each year was significantly greater in the QD group . After 4 yr , the total gain in height SD score was 3.2 + /- 1.2 in the QD group compared to 1.5 + /- 0.5 in the TIW group ( P = 0.0003 ) . The height SD score at 4 yr was 0.2 in the QD group ( pretreatment , -2.9 ) compared to -1.4 in the TIW group ( pretreatment , -2.9 ) . After 4 yr of rhGH treatment , the increment in bone age was similar in the QD ( 4.9 + /- 1.0 yr ) and TIW ( 4.8 + /- 1.1 yr ) groups . The change in height age minus the change in bone age was more favorable in the QD ( 1.2 + /- 0.8 yr ) than in the TIW ( 0.0 + /- 0.9 yr ) group ( P = 0.003 ) . The mean age at onset of puberty in boys was the same in the QD ( 13.2 yr ) and TIW ( 13.0 yr ) groups ( P = 0.71 ) , and the mean bone age at the start of puberty was also similar ( 11.5 in QD and 11.3 in TIW groups ; P = 0.66 ) . The advantages of QD rhGH treatment in prepubertal GH-deficient children after 4 yr were additional gains of 1.7 height SD score and 9.7 cm in height over those treated with the TIW regimen ( P = 0.0002 )
For height outcome , articles were limited to studies reporting adult height and to systematic review s. FINDINGS Recombinant human growth hormone therapy of children with idiopathic short stature increases height in some children .
The cost-benefit ratio is controversial .
AND RELEVANCE Growth hormone treatment may be considered in some children with idiopathic short stature
IMPORTANCE Approximately 2 % of children are defined as having short stature .
Deciding when to pursue recombinant human growth hormone therapy to increase adult height is controversial .
OBJECTIVE To review the management of children with idiopathic short stature , including diagnostic evaluation and therapeutic options .