A new and accurate prediction model for growth response to growth hormone treatment in children with growth hormone deficiency

Abstract

Objective: To identify parameters which predict individual growth response to recombinant human GH (rhGH) therapy and to combine these parameters in a prediction model. Design: Fifty-eight prepubertal patients with GH deficiency (17 females) participated in this prospective multicenter trial with 1 year of follow-up. Methods: Auxological measurements, parameters of GH status and markers of bone metabolism were measured at baseline and at 1, 3 and 6 months after the start of rhGH treatment. Correlations with height velocity during the first 12 months of treatment HV 12 were calculated. Prediction models were derived by multiple regression analysis. Results: The model which best predicted HV 12 combined the following parameters: pretreatment bone age retardation as a fraction of chronological age, pretreatment serum levels of IGF-I, urinary levels of deoxypyridinoline (a marker of bone resorption) after 1 month of treatment and height velocity after 3 months of treatment. This model explained 89% of the variation in HV 12 with a standard deviation of the residuals of 0.93 cm/year. Defining successful rhGH therapy as a doubling of pretreatment height velocity, the model had a specificity of 90% and a sensitivity of 100% in predicting therapeutic success. Conclusions: This model is an accurate and practicable tool to predict growth response in GH-deficient children. It may help to optimize rhGH therapy by individual dose adjustment and contribute to improved overall outcomes.European Journal of Endocrinology 144 13±20

Growth response to growth hormone treatment in patients with SHOX deficiency can be predicted by the Cologne prediction model

“…Growth prediction by the Cologne prediction model was applied earlier to patients with GH deficiency [21,23]. Compared to our data in patients with SHOX deficiency, prediction of growth response in GH deficiency seems to be more accurate [21][22][23].…”

“…The growth prediction model has been described in detail by Schoenau and colleagues [21]. The model was first established in children with GH deficiency during a prospective multicenter trial where patients were treated with GH at a fixed dosage.…”

“…Various prediction models have been described in the past [20,21]. A comparatively accurate method is the Cologne prediction model developed in children with GH deficiency [21], which attempts to identify children with a poor GH treatment response early, to allow timely dose adjustments or even discontinuation of treatment. This model predicts the first-year HV after a 3-month treatment course with GH.…”

“…This model predicts the first-year HV after a 3-month treatment course with GH. It includes the following variables: relative bone age (BA) retardation and serum insulin-like growth factor-I (IGF-I) concentration at the start of GH treatment, deoxypyridinoline (DPD) measured 1 month after the start of treatment and annualized HV after the first 3 months [21].…”

Growth and growth hormone: recent papers on efficacy and adverse effects of growth hormone and World Health Organisation growth standards

“…Among several prediction models developed to predict growth response, the Cologne prediction model is a model developed to predict growth response in children with GH deficiency. The Cologne prediction model measures the relative bone age retardation, serum IGF-1 at onset of therapy, deoxypyridinoline after 1 month of treatment and annualized height velocity after the first 3 months [9]. It predicts the first year height velocity after 3 months of treatment.…”