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Growth hormone used in puberty effective in improving height in small children
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Although GH treatment is efficacious in improving height in short children born small for gestational age, little is known on its effect when started during adolescence. However, new data from a Dutch study have shown that GH treatment was beneficial in improving height in this population.
“It is assumed that GH treatment started during puberty has only limited effect because by that time the epiphyseal maturation has been activated. Postponement of puberty by GnRH analog (GnRHa) can delay epiphyseal maturation by suppressing sex steroid hormones,” researchers wrote. “Growth data during and after combined GH and GnRHa (GH/GnRHa) treatment in short SGA children are lacking.”
Researchers conducted a longitudinal, randomized, dose-response GH trial from December 2003 to 2007, in which they included 121 short small for gestational age (SGA; 60 boys) children aged at least 8 years. Uncensored case analyses were completed on 84 children who reached adult height (AH), and intention-to-treat analyses were done on all children. Additionally, the researchers examined growth during 2 years of combined GH/GnRHa and the following GH treatment until the AH in a subgroup of 40 pubertal children with a height of less than 140 cm at the beginning of the study.
Short SGA children began treatment at approximately 11.2 years. At this time, 46% had already started puberty, according to data. The average height increased from –2.9 at the beginning of the study to –1.7 SD score (SDS) at AH (P<.001).
Administering GH 2 mg/m2 per day vs. 1 mg/m2 per day during puberty resulted in significantly better AH (P=.001). This was unchanged following adjustments. Moreover, AH was similar in children who began puberty at less than 140 cm and received GH/GnRHa, compared with children who began puberty greater than 140 cm and received only GH (P=.795).
“GH treatment in our group of older short SGA children resulted in 1.2 SDS height gain, bringing 62% of the adolescents into the normal AH range,” the researchers wrote.
Researchers wrote that pubertal children with a poor AH outlook can benefit from the combined GH/GnRHa treatment.
Disclosure: Hokken-Koelega received an independent research grant from Pfizer B.V. The Netherlands. All other researchers report no relevant financial disclosures.
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