Decreased <scp>GH</scp> dose after the catch‐up growth period maintains metabolic outcome in short prepubertal children with and without classic <scp>GH</scp> deficiency

Decker, Ralph; Albertsson‐Wikland, Kerstin; Kriström, Berit; Halldin, Magnus M.; Dahlgren, Jovanna

doi:10.1111/j.1365-2265.2012.04386.x

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Demonstration of the efficacy of lower mean GH doses (0.18 and 0.24 mg/kg/week) during the maintenance phase of the treatment of patients with ISS suggests that growth during the post-catch-up phase is not GH dose dependent and, therefore, represents an important finding that differs from the traditionally held belief that patients with ISS generally require higher-than-average GH dosing due to intrinsic GH resistance [5,16,18]. Our finding is in agreement with that of Decker et al [19], who studied 27 children with ISS who had their GH doses reduced by 50% after an initial 2-year catch-up phase. The authors found that ‘… serum IGF-I is no longer the major growth factor in the maintenance growth period when channel-parallel growth has been achieved.'…”

Section: Discussionsupporting

confidence: 71%

A 4-Year, Open-Label, Multicenter, Randomized Trial of Genotropin® Growth Hormone in Patients with Idiopathic Short Stature: Analysis of 4-Year Data Comparing Efficacy, Efficiency, and Safety between an Individualized, Target-Driven Regimen and Standard Dosing

et al. 2015

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Background/Aims: Growth hormone (GH) treatment regimens for children with non-GH-deficient, idiopathic short stature (ISS) have not been optimized. To compare the efficacy, efficiency, and safety of an individualized, target-driven GH regimen with standard weight-based dosing after 4 years of treatment. Methods: This is a 4-year, open-label, multicenter, randomized trial comparing individualized, formula-based dosing of Genotropin® versus a widely used ISS dose of Genotropin®. Subjects were prepubertal, had a bone age of 3-10 years for males and 3-9 years for females, were naive to GH treatment, and had a height standard deviation score (Ht SDS) of -3 to -2.25, a height velocity <25th percentile for their bone age, and peak stimulated GH >10 ng/ml. After the first 2 years, the individualized-dosing group was further randomized to either 0.18 or 0.24 mg/kg/week. Results: At 4 years, subjects in all treatment regimens achieved similar average height gains of +1.3 SDS; however, the individualized dosing regimen utilized less GH to achieve an equivalent height gain. Conclusion: Individualized, formula-based GH dosing, followed by a dose reduction after 2 years, provides a more cost-effective growth improvement in patients with ISS than currently employed weight-based regimens.

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Section: Discussionsupporting

confidence: 71%

A 4-Year, Open-Label, Multicenter, Randomized Trial of Genotropin® Growth Hormone in Patients with Idiopathic Short Stature: Analysis of 4-Year Data Comparing Efficacy, Efficiency, and Safety between an Individualized, Target-Driven Regimen and Standard Dosing

et al. 2015

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“…Risk of bias was assessed using the Cochrane risk-of-bias tool based on the following criteria: random sequence generation, allocation concealment, the blinding of participants and personnel, the blinding of outcome assessment, the completeness of outcome data, the selectivity of reporting, and other bias [ 15 ]. Judgements were expressed as “low risk,” “high risk,” or “unclear risk.”…”

Section: Methodsmentioning

confidence: 99%

The effects of glucagon-like peptide-1 receptor agonists on adipose tissues in patients with type 2 diabetes: A meta-analysis of randomised controlled trials

et al. 2022

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Aims Glucagon‑like peptide 1 receptor agonist (GLP-1RA) treatment can improve adipose distribution. We performed this meta-analysis to investigate whether GLP-1RAs preferentially reduce visceral adipose tissue (VAT) over subcutaneous adipose tissue (SAT) in patients with type 2 diabetes. Materials and methods We searched MEDLINE and the Cochrane Library for randomised controlled trials explicitly reporting changes in VAT and SAT. A random-effects model was performed to estimate the weighted mean difference (MD) for VAT and SAT. Heterogeneity among the studies was assessed using I2 statistics, and publication bias was assessed using Egger’s tests. Meta-regression was performed to identify the correlation between changes in adipose tissues and changes in body weight and glycated haemoglobin level. Results Ten trials with 924 patients were enrolled in the meta-analysis. GLP-1RA treatment led to similar absolute area (cm2) reductions in VAT (MD -21.13 cm2, 95% CI [-29.82, -12.44]) and SAT (MD -22.89 cm2, 95% CI [-29.83, -15.95]). No significant publication bias was detected, and this result was stable in the sensitivity and subgroup analyses. Moreover, GLP-1RA treatment resulted in a greater reduction in VAT and SAT in the subgroup with a greater reduction in body weight. The absolute area reduction in VAT was significantly correlated with the reduction in body weight (r = 6.324, p = 0.035). Conclusions GLP-1RA treatment leads to significant and similar absolute reductions in VAT and SAT, and the reduction in adipose tissues may be correlated with the reduction in body weight.

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GH Dose Reduction Maintains Normal Prepubertal Height Velocity After Initial Catch-Up Growth in Short Children

Decker

Albertsson‐Wikland

Kriström

et al. 2018

The Journal of Clinical Endocrinology &Amp; Metabolism

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Decreased GH dose after the catch‐up growth period maintains metabolic outcome in short prepubertal children with and without classic GH deficiency

Abstract: Continued reduced individualized GH treatment after the catch-up growth period is safe and reduces hyperinsulinism. Individualized GH dose can be reduced once the desired height(SDS) is achieved to avoid overtreatment in terms of metabolic outcome.

Cited by 4 publications

References 29 publications

A 4-Year, Open-Label, Multicenter, Randomized Trial of Genotropin® Growth Hormone in Patients with Idiopathic Short Stature: Analysis of 4-Year Data Comparing Efficacy, Efficiency, and Safety between an Individualized, Target-Driven Regimen and Standard Dosing

A 4-Year, Open-Label, Multicenter, Randomized Trial of Genotropin® Growth Hormone in Patients with Idiopathic Short Stature: Analysis of 4-Year Data Comparing Efficacy, Efficiency, and Safety between an Individualized, Target-Driven Regimen and Standard Dosing

The effects of glucagon-like peptide-1 receptor agonists on adipose tissues in patients with type 2 diabetes: A meta-analysis of randomised controlled trials

GH Dose Reduction Maintains Normal Prepubertal Height Velocity After Initial Catch-Up Growth in Short Children

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