Long Term Pulsatile Growth Hormone (GH)-Releasing Hormone Therapy in Children With GH Deficiency*

Abstract

We treated seven GH-deficient children with 3-hourly 1 microgram/kg sc pulses of GHRH-(1-44) for 6 months and 2 micrograms/kg.pulse for another 6 months. Four patients had a serum GH response to iv GHRH before treatment, and an additional patient responded to iv GHRH after 1 month of pulsatile sc GHRH administration. The mean cumulative growth velocity increased from a pretreatment mean of 2.7 +/- 0.2 (+/- SE) to 8.4 +/- 2.5 and 5.4 +/- 0.7 cm/yr after 2 months and 1 yr of treatment, respectively. Low dose pulsatile GHRH therapy was effective in promoting growth in five of seven children, with height gain ranging from 4.4-7.5 cm at the end of 1 yr's therapy. Only one of the two patients who did not respond to GHRH had an improvement in linear growth when they were subsequently treated with synthetic GH. The other patient, a 16.5-yr-old pubertal girl who had both satisfactory GH and somatomedin-C responses during GHRH therapy, did not respond to either GHRH or, later, synthetic GH. The pretreatment serum GH response to iv GHRH, the serum somatomedin-C concentrations, and the peak serum GH response during sc GHRH therapy were not reliable predictors of clinical response.

Acceleration of Growth Rate in Growth Hormone-Deficient Children Treated with Human Growth Hormone-Releasing Hormone

“…Our results are in agreement with those of Low et al (10) who treated seven GH-deficient children with GHRH by pump for 12 months and with the only other 1-yr study published in which GHRH was administered once daily (10 pg/kg/day) (8). However, our results differ in several important respects from the only other large published series (9).…”

Subcutaneous Treatment with Growth Hormone-Releasing Hormone for Short Stature

“…In the two previous studies of long-term GRF therapy the native peptide of GRF( 1 -40)NH2 was given subcuta neously in pulses via an infusion pump [17][18][19]. This therapy was associated with a significant increase in growth rate.…”

Growth Hormone-Releasing Hormone: Clinical Studies and Therapeutic Aspects

“…Firstly, we wish to mimick the physio logical pattern of 5-9 GH pulses observed daily in growing chil dren. Secondly, pulsatile but not continuous GHRH increased pituitary GH content and promoted growth in GH-deficient rats [32], We were successful in improving the growth velocity in 5 of our 7 patients with severe GH deficiency after I year [33]. Treatment was continued for 2-4 years in the 4 remaining pa tients, and growth velocities ranging from 4.5 to 8.2 cm/year were maintained using a dose of 3 pg/kg/pulse.…”