Experience With Human Growth Hormone in Great Britain: The Report of the MRC Working Party

Abstract

The Working Party on human growth hormone (hGH) has during the past decade developed a system for the evaluation and treatment of patients suffering from hGH lack. Today there are nineteen measurement centres in the United Kingdom at which patients are assessed and where the effects of therapy are monitored. The current supply of hGH, which is prepared from pituitary glands collected by pathologists in the National Health Service, is just enough to meet demand, but research conducted on behalf of the Working Party suggests that hGH deficiency is more common than has been thought and that the prevalence may be as high as one in 10 000. If, as is hoped, patients are diagnosed younger and more patients with partial deficiency are recognized, demand may soon outstrip supply. Work is in progress to define better methods of hGH production and optimal dose regimens, both of which will help to minimize the problem of supply and demand. A few children have anti-hGH antibodies, which block growth as a result of treatment. Improved hGH production techniques may result in a less antigenic product and the resolution of this problem. Many of the Working Party's activities began as research and have evolved into service. Because of this shift in emphasis, and although much research is still to be done, responsibility for provision of treatment with hGH transferred from the Medical Research Council to the Department of Health and Social Security in July 1977.

Multicenter Clinical Trial to Evaluate the Therapeutic Use of Recombinant Growth Hormone from Mammalian Cells in the Treatment of Growth Hormone Neurosecretory Dysfunction

“…Moreover, 12 out of 16 patients (75%) increased their growth velocity more than 2 cm/year, and the adult height prediction was also improved (mean increase of 0.5 SDS). These findings, even though they are in agreement with those reached by other authors in the treatment of this syn drome [1,[5][6][7] are similar to those observed in short stature, but normal GH secretion in patients with etiolo gies different from GHND [17][18][19][20][21] is clearly lower than that observed in the treatment of growth failure due to classical GH deficiency (GHD) with the same, or even lower, therapeutic regimen [13][14][15][16].…”

“…in the release of pituitary GH secondary to abnormalities in neurotransmitter path ways which may result in decreased GHRH and/or increased somatostatin secretion [1,12]; however, at the present time, the etiology underlying this disorder still remains unknown, and an adequate therapeutic regimen has not been established yet. In this sense, although the dosage used here may be considered as a low dosage, it is within the range of that habitually employed in growth failure treatment due to GH deficiency, and it has widely been demonstrated to be effective [13][14][15][16], and, in fact, is one of the most common dosages used by pediatric endocrinologists.…”

Effects of Growth Hormone on Craniofacial Growth

“…Because catch-up growth after GH replacement therapy is greatest during the first 2 years, 11,12 we set the cut-off between the short-and long-term therapy groups as 2 years of GH therapy.…”

Effect of growth hormone on short normal children.

“…criteria before entry into the study and have: (1) a growth velocity standard deviation score between 0 and -0-8 in the first year of the study; (2) skeletal age less than 10 years; (3) 28-2 (9-1) mU/l in the control group). Children in the control group were slightly taller, but height velocities were identical in the two groups.…”