Human Growth Hormone in Pituitary Infantilism

Trafford, J. A. P.; Lillicrap, D.A.; Lessof, M. H.

doi:10.1016/s0140-6736(63)91801-4

Cited by 20 publications

(7 citation statements)

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“…The development of antibodies to hGH developing during treatment with hGH was first observed by Trafford et al (7) in England, and by Roth et al (92) in the United States. Shortly thereafter Prader's group (93) reported that resistance to growth hormone treatment due to antibodies to hGH developed in three of their patients, and Parker et al (94) reported similar observations in one of their growth hormone treated children.…”

Section: Antibodies To Human Growth Hormonementioning

confidence: 92%

“…Scattered additional reports of hGH therapy subsequently appeared (2)(3)(4)(5)(6)(7)(8), and by 1964 it was clear that hGH stimulated linear growth in patients with growth hormone deficiency. Additional preliminary observations were reported over the next several years from the United States (9)(10)(11)(12), Switzerland (13,14), Great Britain (15) and Norway (16,17).…”

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confidence: 99%

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Human Pituitary Growth Hormone (hGH) Therapy in Growth Hormone Deficiency

1983

Endocrine Reviews

153

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This review has attempted to answer a number of questions regarding human growth hormone therapy in growth hormone deficiency. I believe that the available data support several conclusions which form a suggested current approach to the clinical use of hGH. While these conclusions are derived from data obtained using pituitary growth hormone, it is likely that they are applicable to growth hormone manufactured by recombinant DNA technology, as well. Treatment should be begun as early as the diagnosis can be made in anticipation of a better initial and long-term response in younger patients. Growth hormone should be administered on the basis of body weight in an initial dose of 0.06-0.10 unit/kg 3 times a week. Growth hormone may be administered either intramuscularly or subcutaneously. Therapy should be continuous whenever possible. Treatment should be given until there is no further response which generally will reflect closure of the epiphyses. Associated hormone deficiencies should be adequately treated, and patients should be periodically evaluated for the development of additional deficiencies. Concomitant therapy is not indicated unless deficiencies are clearly demonstrated. Thyroid replacement should be at full dosage, while glucocorticoid replacement should probably not exceed 10-15 mg/m2 x day. Gonadal steroids should be used at the bone age when puberty is expected, and hGH should be continued during pubertal development. There is no general indication for giving anabolic/androgenic steroid in combination with hGH in prepubertal patients. If a waning effect of therapy is observed, the dose of hGH should be incrementally increased, and/or the addition of anabolic/androgenic steroid therapy should be considered. While most reports have focused on the effect of hGH on linear growth, changes in weight, bone age, body proportions, and body composition have also been observed. The effect on bone age is variable, but there is greater enhancement of linear growth than of epiphyseal development in the majority of treated patients. Bone age must be monitored during hGH administration whether or not anabolic/androgenic steroids are used concurrently. Growth hormone administration is remarkably free of side effects. However, neutralizing antibodies to hGH may develop and they should be sought in patients in whom an unexplained decrease in response is observed. Certainly the available incomplete data allow for different conclusions. The expanding supply of hGH should lead to a more systematic evaluation and provide more definite answers to the questions which this review has considered.

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Section: Antibodies To Human Growth Hormonementioning

confidence: 92%

mentioning

confidence: 99%

Human Pituitary Growth Hormone (hGH) Therapy in Growth Hormone Deficiency

1983

Endocrine Reviews

153

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“…The appearance of HGH antibody during the treatment of pituitary dwarfism with HGH had been reported since Trafford et al (1963) and considered to be the most troublesome problem in using HGH. Shizume et al (1970) also reported on HGH antibody for the first time in Japan.…”

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confidence: 99%

Treatment of Idiopathic Pituitary Dwarfism with Human Growth Hormone (KABI)

et al. 1974

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SynopsisEleven patients with idiopathic pituitary dwarfism were treated with KABI human growth hormone (HGH), and clinical effects on a linear growth and HGH antibodies during a course of a treatment were studied. The growth rate was 2.8 to 13.4 cm/year in individual cases, and it was less than 5cm/year in 3 cases. One of them had a marked hypothyroidism and later thyroid replacement therapy increased a growth rate definitely. In other 2 cases, HGH antibodies were thought to be the cause of ineffectiveness. HGH antibodies with high titers were found in 4 cases before starting KABI HGH. All of those 4 cases had received Raben's HGH for 1 to 4years just preceding to KABI HGH. Antibody titers decreased after switching to KABI HGH in 3 of 4 cases and the restoration of growth was noted in 2 of them. On the contrary, in the rest of the cases, who were treated only with KABI HGH, no antibody developed in 3 cases and antibody of low titer developed in 4 cases. In these 4 cases no attenuation of growth was observed. From the above observations it is concluded that KABI HGH is clinically effective and much less antigenic than Raben's HGH.

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“…Data are reviewed which suggest that aggregated human growth hormone may be responsible for development of antibodies in patients treated with the hormone. (Endocrinology 84: 325,1969) A NUMBER of recent reports (1)(2)(3)(4)(5)(6)(7) have shown that patients treated with human growth hormone can develop antibodies to the material. In some cases the titers of antibody were low and did not nullify the action of the hormone (1)(2)(3).…”

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confidence: 99%

“…(Endocrinology 84: 325,1969) A NUMBER of recent reports (1)(2)(3)(4)(5)(6)(7) have shown that patients treated with human growth hormone can develop antibodies to the material. In some cases the titers of antibody were low and did not nullify the action of the hormone (1)(2)(3). In an almost equally large group of patients, the concentration of antibody was high (4)(5)(6)(7) and in this group cessation of growth and failure to retain nitrogen were noted in some cases.…”

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confidence: 99%

Aggregate-Free Human Growth Hormone. I. Isolation by Ultrafiltration¹

1969

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A procedure is described for the preparation of human growth hormone by a process of ultrafiltration. The method is rapid, requiring only 2 days to complete; and a yield of 8 mg/pituitary gland can be obtained consistently. The material has a potency equal to or greater than that of other preparations which are used for clinical studies. No organic solvent, extreme pH, or drying process is used and, therefore, denaturation and/or aggregation reactions are minimized. The gonadotrophins and thyrotropin are obtained in a side fraction. Data are reviewed which suggest that aggregated human growth hormone may be responsible for development of antibodies in patients treated with the hormone. (Endocrinology 84: 325, 1969)

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Human Growth Hormone in Pituitary Infantilism

Cited by 20 publications

References 4 publications

Human Pituitary Growth Hormone (hGH) Therapy in Growth Hormone Deficiency

Human Pituitary Growth Hormone (hGH) Therapy in Growth Hormone Deficiency

Treatment of Idiopathic Pituitary Dwarfism with Human Growth Hormone (KABI)

Aggregate-Free Human Growth Hormone. I. Isolation by Ultrafiltration¹

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Human Growth Hormone in Pituitary Infantilism

Cited by 20 publications

References 4 publications

Human Pituitary Growth Hormone (hGH) Therapy in Growth Hormone Deficiency

Human Pituitary Growth Hormone (hGH) Therapy in Growth Hormone Deficiency

Treatment of Idiopathic Pituitary Dwarfism with Human Growth Hormone (KABI)

Aggregate-Free Human Growth Hormone. I. Isolation by Ultrafiltration1

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Aggregate-Free Human Growth Hormone. I. Isolation by Ultrafiltration¹