Comparison of weight‐ <i>vs</i> body surface area‐based growth hormone dosing for children: implications for response

Hughes, Ian; Harris, Mark; Cotterill, Andrew; Ambler, Geoffrey; Cowell, Christopher T.; Cutfield, Wayne S.; Werther, George A.; Choong, Catherine S

doi:10.1111/cen.12315

Cited by 12 publications

(19 citation statements)

References 32 publications

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“…In this context it is noteworthy that surface area based dosing (using m 2 ) as opposed to weight based dosing (using kg) results in relatively higher growth hormone doses in infants and younger children than older children [35]. Whether the dose used in Australia is sufficient to also substantially improve the lean to fat mass ratio in the long term is currently under investigation in our cohort as is the thyroid function and respiratory function.…”

Section: Accepted Manuscriptmentioning

confidence: 98%

Low dose growth hormone treatment in infants and toddlers with Prader-Willi syndrome is comparable to higher dosage regimens

Scheermeyer

Harris

Hughes

et al. 2017

Growth Hormone & IGF Research

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Section: Accepted Manuscriptmentioning

confidence: 98%

Low dose growth hormone treatment in infants and toddlers with Prader-Willi syndrome is comparable to higher dosage regimens

Scheermeyer

Harris

Hughes

et al. 2017

Growth Hormone & IGF Research

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“…Differences in dose calculations between the weight-and BSA-based approaches are most prominent at younger ages and with obesity. Hughes et al [90] noted that older children receive a lower total GH dose if BSA dosing is used, rather than weight-based dosing. Rigorous studies comparing weight-based with BSA-based dosing have not been conducted; thus, there is insufficient evidence to recommend one dosing regimen over the other.…”

Section: Dosing Of Gh Treatment For Patients With Ghdmentioning

confidence: 99%

Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency

DiVall²,

et al. 2016

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Background/Aims: On behalf of the Drug and Therapeutics, and Ethics Committees of the Pediatric Endocrine Society, we sought to update the guidelines published in 2003 on the use of growth hormone (GH). Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, GH deficiency (GHD), and primary IGF-I deficiency (PIGFD), we focused on these three diagnoses, thereby adding recombinant IGF-I therapy to the GH guidelines for the first time. Methods: This guideline was developed following the GRADE approach (Grading of Recommendations, Assessment, Development, and Evaluation). Results: This guideline provides recommendations for the clinical management of children and adolescents with growth failure from GHD, ISS, or PIGFD using the best available evidence. Conclusion: The taskforce suggests that the recommendations be applied in clinical practice with consideration of the evolving literature and the risks and benefits to each individual patient. In many instances, careful review highlights areas that need further research.

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“…At 3 years and 2 months, her height was 80cms (SDS −3.86) (<3 rd percentile on WHO growth chart, <1 st percentile on CDC growth chart) with a height velocity of 5cms/year. GH treatment was commenced at 3 years and 3 months with a starting dose of 4.9 mg/m 2 /week (0.2 mg/kg/week) [7], under the Pharmaceutical Benefits Scheme Growth Hormone Program for ‘Short stature and slow growth’ [8]. This category utilises the following auxological parameters on the CDC growth charts; height <1 st percentile on the CDC growth chart and low height velocity (<3 rd percentile CDC growth chart).…”

Section: Case Presentationmentioning

confidence: 99%

Short stature and hypoparathyroidism in a child with Kenny-Caffey syndrome type 2 due to a novel mutation in FAM111A gene

Abraham

Dong

Tang

et al. 2017

Int J Pediatr Endocrinol

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BackgroundHypoparathyroidism in children is a heterogeneous group with diverse genetic etiologies. To aid clinicians in the investigation and management of children with hypoparathyroidism, we describe the phenotype of a 6-year-old child with hypoparathyroidism and short stature diagnosed with Kenny-Caffey syndrome (KCS) Type 2 and the subsequent response to growth hormone (GH) treatment.Case presentationThe proband presented in the neonatal period with hypocalcemic seizures secondary to hypoparathyroidism. Her phenotype included small hands and feet, hypoplastic and dystrophic nails, hypoplastic mid-face and macrocrania. Postnatal growth was delayed but neurodevelopment was normal. A skeletal survey at 2 years of age was suggestive of KCS Type 2 and genetic testing revealed a novel de novo heterozygous mutation c.1622C > A (p.Ser541Tyr) in FAM111A. At 3 years and 2 months, her height was 80cms (SDS −3.86). She had normal overnight GH levels. GH therapy was commenced at a dose of 4.9 mg/m2/week for her short stature and low height velocity of 5cms/year. At the end of the first and second years of GH treatment, height velocity was 6.5cms/year and 7.2cms/year, respectively with maximal dose of 7.24 mg/m2/week.ConclusionThis case highlights the phenotype and the limited response to GH in a child with genetically proven KCS type 2. Long-term registries monitoring growth outcomes following GH therapy in patients with rare genetic conditions may help guide clinical decisions regarding the use and doses of GH in these conditions.

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Comparison of weight‐ vs body surface area‐based growth hormone dosing for children: implications for response

Abstract: Growth hormone doses can be accurately converted between formats. Surface area-based GH dosing is likely to result in a reduced height response as children become heavier when compared with weight-based GH dosing.

Cited by 12 publications

References 32 publications

Low dose growth hormone treatment in infants and toddlers with Prader-Willi syndrome is comparable to higher dosage regimens

Low dose growth hormone treatment in infants and toddlers with Prader-Willi syndrome is comparable to higher dosage regimens

Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency

Short stature and hypoparathyroidism in a child with Kenny-Caffey syndrome type 2 due to a novel mutation in FAM111A gene

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