Growth Hormone Dose-Dependent Pubertal Growth: A Randomized Trial in Short Children with Low Growth Hormone SecretionAlbertsson-Wikland K.a · Kriström B.b · Lundberg E.b · Aronson A.S.c · Gustafsson J.d · Hagenäs L.e · Ivarsson S.-A.f · Jonsson B.d · Ritzén M.e · Tuvemo T.d · Westgren U.f · Westphal O.a · Åman J.g
aGöteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, bPediatrics Unit, Department of Clinical Sciences, Umeå University, Umeå, cDepartment of Pediatrics, Halmstad Hospital, Halmstad, dDepartment of Women's and Children's Health, Uppsala University, Uppsala, eDepartment of Women's and Children's Health, Karolinska Institute, Stockholm, fDepartment of Pediatrics, Lund University, Malmö, and gSchool of Health and Medical Sciences, Örebro University, Örebro, Sweden
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Article / Publication Details
Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i.e. idiopathic isolated GH deficiency. Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH 33 µg/kg/day for ≥1 year. They were randomized to receive 67 µg/kg/day (GH67) given as one (GH67×1; n = 35) or two daily injections (GH33×2; n = 36), or to remain on a single 33 µg/kg/day dose (GH33×1; n = 40). Growth was assessed as heightSDSgain for prepubertal, pubertal and total periods, as well as AHSDS versus the population and the midparental height. Results: Pubertal heightSDSgain was greater for patients receiving a high dose (GH67, 0.73) than a low dose (GH33×1, 0.41, p < 0.05). AHSDS was greater on GH67 (GH67×1, -0.84; GH33×2, -0.83) than GH33 (-1.25, p < 0.05), and heightSDSgain was greater on GH67 than GH33 (2.04 and 1.56, respectively; p < 0.01). All groups reached their target heightSDS. Conclusion: Pubertal heightSDSgain and AHSDS were dose dependent, with greater growth being observed for the GH67 than the GH33 randomization group; however, there were no differences between the once- and twice-daily GH67 regimens.
© 2014 S. Karger AG, Basel
Article / Publication Details
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