Factors Influencing the One- and Two-Year Growth Response in Children Treated with Growth Hormone: Analysis from an Observational Study

Ross, Judith; Lee, Peter A.; Gut, Robert; Germak, John

doi:10.1155/2010/494656

Cited by 28 publications

(29 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently published ANSWER Program data on patients with Noonan syndrome with a mean referral age of 9 years showed that baseline age was negatively correlated with ΔHSDS after 1 or 2 years of GH treatment, indicating that older baseline ATS resulted in lower ΔHSDS [ 27 – 29 ]. In the present study, analysis of the relationship between age at initiation of GHT and near-adult HSDS in patients with GHD, ISS, and TS showed significant negative correlations, which is consistent with previous reports [ 13 , 15 , 28 ]. The results of the current analysis are among the first to describe the long-term effects of GH treatment, including an increase in HSDS at the time of NAH, in children who initiated GHT at an older age.…”

Section: Discussionsupporting

confidence: 93%

“…Patients identified using HV and age criteria had sufficient visit frequency from which to assess HV consistent with NAH. As noted in previous publications from the ANSWER Program pediatric patients are generally excluded from analysis if baseline chronologic age (CA) was <1 year or >18 years, or if baseline values of key variables were missing or deemed inconsistent or implausible (e.g., lack of height information at baseline; baseline height <35 cm or >200 cm; baseline HSDS < -5 or > +2) [ 13 , 15 ]. The current study assessed children with GHD (patients with IGHD and MPHD), ISS, and TS who reached NAH after treatment with GH.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed skeletal maturation: results from the ANSWER Program

Ross

Lee

Gut

et al. 2015

Int J Pediatr Endocrinol

Self Cite

View full text Add to dashboard Cite

BackgroundA primary goal of recombinant human growth hormone therapy (GHT) in children is attaining normal adult height. In this study, children with growth hormone deficiency (GHD) (including isolated idiopathic growth hormone deficiency [IGHD] and multiple pituitary hormone deficiency [MPHD]), idiopathic short stature (ISS), and Turner syndrome (TS) were evaluated for near-adult height (NAH) and percent achieving NAH within the normal range after approximately 4 years of GHT.MethodsData from the American Norditropin® Studies: Web-Enabled Research (ANSWER) Program were analyzed for NAH from age at treatment start (ATS) (i.e., referral age as defined by age at enrollment in the study) to last clinic visit using one of the following two criteria: 1) age ≥18 years, or 2) if male: ≥16 years and height velocity (HV) <2 cm/year; if female: ≥15 years and HV <2 cm/year. All patients had a baseline height standard deviation score (HSDS) ≤ -2, and either GHD (n = 201), ISS (n = 19), or TS (n = 41). The main outcome measures included HSDS and corrected HSDS (HSDS-target HSDS) in response to GH treatment, and correlation of ATS with NAH HSDS.ResultsMean (± SD) chronological and bone ages at baseline were 14.0 ± 2.1 years and 11.7 ± 2.0 years, respectively, and mean GHT duration was 4.0 ± 1.6 years. Mean HSDS (baseline to NAH; GHD: -2.7 to -1.0; ISS: -2.8 to -1.4; TS: -3.0 to -1.8) and mean corrected HSDS (baseline to NAH; GHD: -2.1 to -0.3; ISS: -2.1 to -0.6; TS: -1.8 to -0.6) increased across diagnostic indications. Percentages of patients reaching near-adult HSDS > -2 were GHD: 87.6%; ISS: 78.9%; TS: 65.8%. Significant negative correlations were found between ATS and NAH HSDS when analyzed by sex.ConclusionsDespite a relatively advanced childhood age, the majority of GH-treated patients attained mean near-adult HSDS within the normal range (HSDS > -2). Negative correlations of ATS with near-adult HSDS indicate that an earlier age at treatment start would likely have resulted in greater adult height achieved in both male and female patients.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed skeletal maturation: results from the ANSWER Program

Ross

Lee

Gut

et al. 2015

Int J Pediatr Endocrinol

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, different from patients reported in the literature, our patients’ population received rGH therapy at an earlier age for all indications (9.0 years) compared to the French SAGhE Study (11.0 years) [ 17 ]. Also, children with GHD in our study started rGH therapy at median age of 6.4 years compared to 10.2 years from the International ANSWER Registry [ 4 ], 10.8 years from USA [ 18 ], 9.2 years from the Pfizer International Growth Database (KIGS) [ 19 ] and 8.25 years from Taiwan [ 20 ]. For children with ISS, the age of initiation of therapy in a systematic review ranged from 6.1 to 12.9 years [ 21 ] compared to 10.6 years in our study.…”

Section: Discussionmentioning

confidence: 99%

Recombinant growth hormone therapy in children with short stature in Kuwait: a cross-sectional study of use and treatment outcomes

et al. 2015

View full text Add to dashboard Cite

BackgroundRecombinant Growth hormone (rGH) therapy is approved in many countries for treatment of short stature in a number of childhood diagnoses. Despite the increasing body of international literature on rGH use, there is paucity of data on rGH use in Kuwait and the broader Middle-East which share unique ethnic and socio-cultural backgrounds. This study aimed to describe the pattern of use and treatment outcomes of rGH therapy in Kuwait.MethodsThis is a cross-sectional retrospective review of children treated with rGH in the Department of Pediatrics, in a major hospital in Kuwait between December 2013 and December 2014. Data were extracted using standard data extraction form and the response to rGH therapy was defined as a gain of ≥ 0.3 standard deviation score (SDS) of height per year.ResultsA total of 60 children were treated with rGH in the center. Their Median (Interquartile) age at rGH initiation was 9.0 (6.2, 10.7) years. The most common indications for rGH therapy were Growth Hormone Deficiency (GHD) 23 (38.3 %), Idiopathic Short Stature (ISS) 12 (20.0 %) and Small for Gestational Age (SGA) 9 (15.0 %). After excluding patients with TS, no significant differences were found in gender of those who received rGH therapy in all indications combined or in each group (p ≥ 0.40). At 1-year follow-up, children in all groups had median height SDS change of ≥ 0.3 SDS except for children with ISS. Age at rGH initiation was negatively associated with 1-year treatment response, Adjusted odds ratio (AOR) 0.56 (95 % CI: 0.04–1.49); p = 0.011).ConclusionsGHD is the most common indication of rGH therapy. All indications except for ISS showed significant 1-year treatment response to therapy. Treatment outcomes in patients with ISS should be further investigated in Kuwait. Younger age at initiation of rGH therapy was independently associated with significant response to therapy suggesting the importance of identifying children with short stature and prompt initiation of rGH therapy.

show abstract

“…Recent data from the American Norditropin Studies: Web-Enabled Research (ANSWER) Program® also showed that pediatric patients treated with a mean starting rhGH dose of 50 μg/kg/day showed a substantial increase in HSDS after 2 years of follow-up; at the end of 2 years, the ΔHSDS was 1.0 for patients with GHD and multiple pituitary hormone deficiency [21]. In addition, the change from baseline in HSDS was greater in prepubertal than in pubertal GHD patients.…”

Section: Discussionmentioning

confidence: 99%

Prepubertal Children with Growth Hormone Deficiency Treated for Four Years with Growth Hormone Experience Dose-Dependent Increase in Height, but Not in the Rate of Puberty Initiation

et al. 2013

View full text Add to dashboard Cite

Background/Aims: Limited data exist on long-term dose response to recombinant human growth hormone (rhGH) in prepubertal GH-deficient (GHD) children. The effect of low, intermediate, and high-dose rhGH (25, 50, and 100 μg/kg/day, respectively) on growth and puberty in children with GHD was investigated for 48 months. Methods: A prospective, dose-response study in 111 patients (aged 3-16 years) evaluated growth velocity (cm/year), height standard deviation score (HSDS), corrected HSDS, bone age/chronologic age ratio, body mass index SDS, and the percentage starting puberty. Results: Dose-related increases were observed in growth velocity (p < 0.001), HSDS (p < 0.001), and corrected HSDS (p < 0.001) from baseline to 48 months. Increases in the bone age/chronologic age ratio (p = 0.043) and body mass index SDS (p = 0.018) occurred up to 36 months at intermediate and high doses versus low-dose rhGH; increases at 48 months were not significant. No significant differences in growth were found between intermediate and high doses of rhGH. Percentages of rhGH-treated patients starting puberty at each dose were equivalent (p = 0.607). Conclusions: rhGH, 50 and 100 μg/kg/day, induced greater growth than 25 μg/kg/day without altering the proportion of children starting puberty. The maximum approved dose for pubertal patients (100 μg/kg/day) is not required or recommended for prepubertal children with GHD.

show abstract

Factors Influencing the One- and Two-Year Growth Response in Children Treated with Growth Hormone: Analysis from an Observational Study

Cited by 28 publications

References 27 publications

Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed skeletal maturation: results from the ANSWER Program

Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed skeletal maturation: results from the ANSWER Program

Recombinant growth hormone therapy in children with short stature in Kuwait: a cross-sectional study of use and treatment outcomes

Prepubertal Children with Growth Hormone Deficiency Treated for Four Years with Growth Hormone Experience Dose-Dependent Increase in Height, but Not in the Rate of Puberty Initiation

Contact Info

Product

Resources

About