Differences in Response to Recombinant Growth Hormone Therapy on Height Gain in Patients with Idiopathic Short Stature Vs. Patients with Growth Hormone Deficiency

Alzahrani, Ali K; Algethami, Abdulmohsin; Barnawi, Ghassan M; Meftah, Ibraheem; Alshanqiti, Ammar; Al-Hashmi, Hashim; Khan, Mohammed Anwar; Felimban, Nailah

doi:10.7759/cureus.7319

Cited by 2 publications

(4 citation statements)

References 24 publications

(32 reference statements)

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“…In this study, the mean age before starting GH therapy was 12.55 years, the mean initial bone age was 9.27 years (delayed), the mean initial height SD was − 3.42 SD, the mean initial weight SD was − 2.65 SD, and the mean mid-parental height SD was − 0.97 SD. These results were comparable to those of Alzahrani et al [ 16 ] where mean age was 10.77 years ± 2.48 and the mean initial height was 125.35 cm ± 11.72.…”

Section: Discussionsupporting

confidence: 91%

“…These results were similar to the results of Quitmann et al [ 1 ] with mean height SD after 1 year treatment − 2.06 SD in the ISS group, − 1.91 SD in the GHD group (best response), and − 2.05 SD in the SGA group. However, Alzahrani et al [ 16 ] found no significant differences in height gain after treatment between the GHD and ISS groups.…”

Section: Discussionmentioning

confidence: 99%

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Growth hormone therapy response in children with short stature

Gad

Shamma

Elmonem

et al. 2023

Egypt Pediatric Association Gaz

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Background Short stature is one of the main causes of children referral to pediatric endocrinologists. Common etiologies include idiopathic growth hormone deficiency (IGHD), small for gestational age (SGA), and idiopathic short stature (ISS). Objectives The aim of this study was to assess and compare the response of children with IGHD, ISS, and SGA to growth hormone (GH) therapy. Methods This was a mixed cohort study that included 40 children with short stature (classified into IGHD, ISS, and SGA) following up at Diabetes, Endocrine, and Metabolism Pediatric Unit (DEMPU), Cairo University Children’s Hospital. Ages ranged between 3 and 18 years. Recruited cases were evaluated for their 1-year response to GH therapy. In addition to history taking, physical examination, and anthropometric measurements, serum levels of IGF-1 were assayed at recruitment. Results Among the 3 groups, height gain (cm/year) was significantly higher in the IGHD group (6.59 cm/year), followed by the ISS (4.63 cm/year) and SGA groups (4.46 cm/year) (p = 0.039). Using the Bang criterion for first-year responsiveness to GH therapy, most cases (30/40, 75%) were considered poor responders. Conclusion There is a male predominance in children seeking medical advice for short stature. Starting GH therapy at an older age was associated with poor response. Children with IGHD respond better to GH therapy than those with ISS and SGA.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Growth hormone therapy response in children with short stature

Gad

Shamma

Elmonem

et al. 2023

Egypt Pediatric Association Gaz

View full text Add to dashboard Cite

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“…7 This was consistent with the fact that the dose of GH for patients with ISS approved by the FDA (2003) was generally 0.15 2 GV changes after rhGH treatment, the error bar represents standard deviation. 15 From the start of and up to two years of treatment, the rhGH dose was significantly higher in the ISS group compared with the GHD group. With the extension of the rhGH treatment time, the GV of the two groups at the second year of treatment was lower than at the first but the difference between the ISS and GHD groups was not statistically significant.…”

Section: Discussionmentioning

confidence: 89%

“…An existing study revealed that following rhGH treatment for ISS, the treatment response indicated a significant dose-dependent pattern, where a higher unit dose was more effective than a lower unit dose. 14 Alzahrani et al 15 retrospectively analyzed 110 children (76 with GHD and 34 with SGA). Their research considered the starting age, treatment time, and treatment dose as the main influencing factors on growth rate.…”

Section: Discussionmentioning

confidence: 99%

A Real-World Study of Recombinant Human Growth Hormone in the Treatment of Idiopathic Short Stature and Growth Hormone Deficiency

Gou

Cheng

Leng

et al. 2022

TCRM

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Objective: This study aimed to evaluate the clinical efficacy of recombinant human growth hormone (rhGH) in the treatment of children with idiopathic short stature (ISS) and growth hormone deficiency (GHD) and to explore the related factors affecting treatment efficacy. Methods:The current research reflects a real-world study. A total of 79 patients with ISS and 95 patients with GHD (both groups pre-puberty) who had been treated with rhGH for more than one year from January 2010 to September 2019 were included in this study. The patients were divided into two groups, ie, an ISS and a GHD group, respectively. The growth indexes, such as chronological age (CA), bone age (BA), height standard deviation score (HtSDS), insulin-like growth factor-1 (IGF-1) SDS, and body mass index were recorded and compared between the two groups before and after treatment. The treatment efficacy was evaluated according to changes in HtSDS before and after treatment, and the influencing factors of clinical efficacy were analyzed using a multivariate regression model. Results: At the start of treatment, the differences in CA, BA, height, weight, sexual development stage, HtSDS, mid-parental height SDS, and IGF-1 SDS between the two groups were not statistically significant (P > 0.05). However, the initial dose of rhGH in the GHD group was significantly lower than in the ISS group (P < 0.001). Following rhGH treatment, the differences in CA, BA, BA/CA ratio, and IGF-1 SDS measured at 6, 12, 18, and 24 months between the ISS and GHD groups were not statistically significant, while the difference in HtSDS measured at 6 months was statistically significant. With the extension of rhGH treatment time, the annual growth rate (GV) gradually decreased, and the difference between HtSDS and the baseline gradually increased; however, the differences between the ISS and GHD groups were not statistically significant. The most important factor affecting the treatment efficacy for patients with ISS was age at the start of treatment; the most important factors affecting the treatment efficacy for patients with GHD were age and IGF-1 SDS. Conclusion: Recombinant human growth hormone treatment can significantly improve the height of patients with ISS and GHD. There was no significant difference in growth rate between patients with ISS and those with GHD at relatively high doses. The common factor affecting the treatment efficacy of the two groups was the age at the start of treatment. During treatment, monitored data indicated that rhGH treatment of GHD and ISS thyroid function showed a clinical phenomenon in the form of increased free triiodothyronine, rather than hypothyroidism, which was rarely reported in existing studies.

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Differences in Response to Recombinant Growth Hormone Therapy on Height Gain in Patients with Idiopathic Short Stature Vs. Patients with Growth Hormone Deficiency

Cited by 2 publications

References 24 publications

Growth hormone therapy response in children with short stature

Growth hormone therapy response in children with short stature

A Real-World Study of Recombinant Human Growth Hormone in the Treatment of Idiopathic Short Stature and Growth Hormone Deficiency

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