Long-Term Response to GH Therapy in Short Children With a Delayed Infancy-Childhood Transition (DICT)

Albertsson‐Wikland, Kerstin; Kriström, Berit; Jonsson, Björn; Hochberg, Zèev

doi:10.1203/pdr.0b013e3182139243

Cited by 10 publications

(15 citation statements)

References 29 publications

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“…Total gain in height seems to correlate with first-year responsiveness, while bone age delay may [198] or may not be predictive [111,202] . Albertsson-Wikland et al [207] also found on re-analysis that height difference with respect to parents, as well as HtSDS and IGF-I SDS at baseline, explained some of the variance of the responses in their study. In a further analysis of these data, Kristrom et al [208] determined that the change in IGF-I SDS from baseline to mean study level was the most important determinant in the long-term growth response; the lower the IGF-I SDS at baseline, the higher was the on-treatment increment in IGF-I SDS.…”

Section: Gh Treatment Of Patients With Issmentioning

confidence: 83%

Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency

DiVall²,

et al. 2016

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Background/Aims: On behalf of the Drug and Therapeutics, and Ethics Committees of the Pediatric Endocrine Society, we sought to update the guidelines published in 2003 on the use of growth hormone (GH). Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, GH deficiency (GHD), and primary IGF-I deficiency (PIGFD), we focused on these three diagnoses, thereby adding recombinant IGF-I therapy to the GH guidelines for the first time. Methods: This guideline was developed following the GRADE approach (Grading of Recommendations, Assessment, Development, and Evaluation). Results: This guideline provides recommendations for the clinical management of children and adolescents with growth failure from GHD, ISS, or PIGFD using the best available evidence. Conclusion: The taskforce suggests that the recommendations be applied in clinical practice with consideration of the evolving literature and the risks and benefits to each individual patient. In many instances, careful review highlights areas that need further research.

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Section: Gh Treatment Of Patients With Issmentioning

confidence: 83%

Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency

DiVall²,

et al. 2016

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“…In fact, a large prepubertal height gain was negative for pubertal gain but positive for total gain. Moreover, a low growth velocity during the first 2 years of life, reflecting a delayed transition from infancy to childhood growth [19], was found to be positive for prepubertal growth response [50], as shown earlier in children with ISS [51]. …”

Section: Discussionmentioning

confidence: 99%

Growth Hormone Dose-Dependent Pubertal Growth: A Randomized Trial in Short Children with Low Growth Hormone Secretion

et al. 2014

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Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i.e. idiopathic isolated GH deficiency. Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH 33 µg/kg/day for ≥1 year. They were randomized to receive 67 µg/kg/day (GH⁶⁷) given as one (GH^67×1; n = 35) or two daily injections (GH^33×2; n = 36), or to remain on a single 33 µg/kg/day dose (GH^33×1; n = 40). Growth was assessed as height_SDSgain for prepubertal, pubertal and total periods, as well as AH_SDS versus the population and the midparental height. Results: Pubertal height_SDSgain was greater for patients receiving a high dose (GH⁶⁷, 0.73) than a low dose (GH^33×1, 0.41, p < 0.05). AH_SDS was greater on GH⁶⁷ (GH^67×1, -0.84; GH^33×2, -0.83) than GH³³ (-1.25, p < 0.05), and height_SDSgain was greater on GH⁶⁷ than GH³³ (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height_SDS. Conclusion: Pubertal height_SDSgain and AH_SDS were dose dependent, with greater growth being observed for the GH⁶⁷ than the GH³³ randomization group; however, there were no differences between the once- and twice-daily GH⁶⁷ regimens.

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“…Our recent research has emphasized the importance of trying to individualize the GH dosing according to responsiveness [11] in order to achieve optimal and safe attainment of the target height [12,13]. The study design and results of the clinical trial have been reported elsewhere [13,14,15].…”

Section: Methodsmentioning

confidence: 99%

When Do Short Children Realize They Are Short? Prepubertal Short Children’s Perception of Height during 24 Months of Catch-Up Growth Hormone Treatment

et al. 2012

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Aim: To examine perceived height during the first 24 months of growth hormone (GH) treatment in short prepubertal children. Methods: Ninety-nine 3- to 11-year-old short prepubertal children with either isolated GH deficiency (n = 32) or idiopathic short stature (n = 67) participated in a 24-month randomized trial of individualized or fixed-dose GH treatment. Children’s and parents’ responses to three perceived height measures: relative height (Silhouette Apperception Test), sense of height (VAS short/tall), and judgment of appropriate height (yes/no) were compared to measured height. Results: Children and parents overestimated height at start (72%, 54%) and at 24 months (52%, 30%). Short children described themselves as tall until 8.2 years (girls) and 9 years (boys). Prior to treatment, 38% of children described their height as appropriate and at 3 months, 63%. Mother’s height, parental sense of the child’s tallness and age explained more variance in children’s sense of tallness (34%) than measured height (0%). Conclusion: Short children and parents overestimate height; a pivotal age exists for comparative height judgments. Even a small gain in height may be enough for the child to feel an appropriate age-related height has been reached and to no longer feel short.

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Long-Term Response to GH Therapy in Short Children With a Delayed Infancy-Childhood Transition (DICT)

Cited by 10 publications

References 29 publications

Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency

Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency

Growth Hormone Dose-Dependent Pubertal Growth: A Randomized Trial in Short Children with Low Growth Hormone Secretion

When Do Short Children Realize They Are Short? Prepubertal Short Children’s Perception of Height during 24 Months of Catch-Up Growth Hormone Treatment

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