Personalized Approach to Growth Hormone Treatment: Clinical Use of Growth Prediction Models

Abstract

The goal of growth hormone (GH) treatment in a short child is to attain a fast catch-up growth toward the target height (TH) standard deviation score (SDS), followed by a maintenance phase, a proper pubertal height gain, and an adult height close to TH. The short-term response variable of GH treatment, first-year height velocity (HV) (cm/year or change in height SDS), can either be compared with GH response charts for diagnosis, age and gender, or with predicted HV based on prediction models. Three types of prediction models have been described: the Kabi International Growth Hormone Study models, the Gothenburg models and the Cologne model. With these models, 50-80% of the variance could be explained. When used prospectively, individualized dosing reduces the variation in growth response in comparison with a fixed dose per body weight. Insulin-like growth factor-I-based dose titration also led to a decrease in the variation. It is uncertain whether adding biochemical, genetic or proteomic markers may improve the accuracy of the prediction. Prediction models may lead to a more evidence-based approach to determine the GH dose regimen and may reduce the drug costs for GH treatment. There is a need for user-friendly software programs to make prediction models easily available in the clinic.

Individualised growth response optimisation (iGRO) tool: an accessible and easy-to-use growth prediction system to enable treatment optimisation for children treated with growth hormone

“…with or without biomarkers, which may account for some of the variability in response [8][9][10][11][12][13]. Growth prediction models (GPMs), incorporating these patient characteristics and modalities of treatment, can be used to predict the growth response to GH of an individual.…”

MECHANISMS IN ENDOCRINOLOGY: Clinical and pharmacogenetic aspects of the growth hormone receptor polymorphism

“…2, allowing a future extensive metaanalysis comparing the three genotype groups. In the current context, the use of the GHR polymorphism, alone or in association with other genetic variants within the GH-IGF-I axis, is of little value in prediction models to estimate the response to rhGH treatment in short children (43).…”

Optimizing growth hormone threapy in chilhood growth hormone defiency

“…Örneğin, BH reseptorü ekzon 3 delesyon polimorfizmi (32,33) veya IGFBP-3 promotor geni -202 A polimorfizminin (34) özellikle ağır BHE vakalarında BH tedavi yanıtını artırabileceği öne sürülmektedir. Bu konunun ayrıntıları bu derlemenin kapsamı dışın-da olup, bu konuda çalışmalar devam etmektedir (35) .…”