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GH Dose Reduction Maintains Normal Prepubertal Height Velocity After Initial Catch-Up Growth in Short Children
Univ Gothenburg, Gothenburg Pediat Growth Res Ctr, Dept Pediat, Inst Clin Sci,Sahlgrenska Acad, S-41685 Gothenburg, Sweden;MVZ Praxis Chilehaus Pediat Endocrinol Androl Int, D-20095 Hamburg, Germany.ORCID iD: 0000-0003-3623-8128
Univ Gothenburg, Dept Physiol Endocrinol, Inst Neurosci & Physiol, Sahlgrenska Acad, S-41685 Gothenburg, Sweden.
Umea Univ, Dept Pediat, Inst Clin Sci, S-90187 Umea, Sweden.
Karolinska Inst, Dept Womens & Childrens Hlth, Div Pediat Endocrinol, S-17177 Stockholm, Sweden.
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2019 (English)In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 104, no 3, p. 835-844Article in journal (Refereed) Published
Abstract [en]

Context: GH responsiveness guides GH dosing during the catch-up growth (CUG) period; however, little is known regarding GH dosing during the prepubertal maintenance treatment period.

Objective: To evaluate whether SD score (SDS) channel parallel growth with normal height velocity can be maintained after CUG by reducing the GH dose by 50% in children receiving doses individualized according to estimated GH responsiveness during the catch-up period.

Design and Settings: Prepubertal children (n = 98; 72 boys) receiving GH during CUG (GH deficient, n = 33; non-GH deficient, n = 65), were randomized after 2 to 3 years to either a 50% reduced individualized dose (GHRID; n = 27; 20 boys) or unchanged individualized dose (GHUID; n = 38; 27 boys). Another 33 children (25 boys) continued a standard weight-based dose [43 μg/kg/d (GHFIX)].

Main Outcome Measures: The primary endpoint was the proportion of children with ΔheightSDS within ±0.3 at 1 year after GH dose reduction compared with two control groups: GHUID and GHFIX. The hypothesis was that heightSDS could be maintained within ±0.3 with a reduced individualized GH dose.

Results: For the intention-to-treat population at 1 year, 85% of the GHRIDgroup maintained ΔheightSDS within ±0.3 vs 41% in the GHUIDgroup (P = 0.0055) and 48% in the GHFIXgroup (P = 0.0047). The ΔIGF-ISDS in the GHRID group was -0.75 ± 1.0 at 3 months (P = 0.003) and -0.72 ± 1.2 at 1 year compared with the GHUID group (0.15 ± 1.2; P = 0.005) and GHFIX group (0.05 ± 1.0; P = 0.02).

Conclusions: Channel parallel growth (i.e., normal height velocity) and IGF-ISDS levels within ± 2 were maintained after completed CUG using a 50% lower individualized dose than that used during the CUG period.

Place, publisher, year, edition, pages
2019. Vol. 104, no 3, p. 835-844
National Category
Pediatrics Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-381823DOI: 10.1210/jc.2018-01006ISI: 000462737000034PubMedID: 30339244OAI: oai:DiVA.org:uu-381823DiVA, id: diva2:1305842
Funder
Swedish Research Council, 522-2005-7238Swedish Research Council, 7509Available from: 2019-04-18 Created: 2019-04-18 Last updated: 2019-04-18Bibliographically approved

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