Introduction: Recombinant GH is an effective treatment for short children who are born small for gestational age(SGA). Short children SGA who fail catch-up growth by 4 years of age are candidates for GH treatment, at a dose of 3570 μg/kg per day. Factors associated with response to GH treatment during the initial 23 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. It is important to know the effectiveness of the treatment in our geographical area and compare the clinical and analytical results with those of other populations.
Objective: The aim is to study the predisposing factors of good response in SGA children treated with rhGH in our community, as well as its possible adverse effects.
Methods: Information from the application protocols for GH treatment has been collected of our geographical area (Northwest Spain) for a period of 10 years. It has been made a descriptive and analytical statistical study using SPSS 20.0. Tests used T-Student and Pearson correlation.
Results: Valid data of 180 patients (52.2% males; 47.8% females) have been obtained. All of them met the standars required by the European Medicines Agency. Background: 12.8% multiple pregnancy; 18.3% associated perinatal pathology; 10.6% associated non-perinatal pathology. Birth information: weight −1.88 SDS; length −2.83 SDS. Information at the beginning of treatment: age 7.39±2.6 years; height −3.16 SDS; growth rate at start −1.74 SDS. 96.1% started treatment before the onset of puberty. Information at one year of treatment: height −2.34 SDS; rate of growth +3.03 SDS. Information at second year of treatment: growth rate +1.48 SDS. The average treatment dose was 0.036 mg/kg per day. No adverse events were reported.
Conclusions: Our results agree with other published series and these are representative of our population. We observe an age of late onset of treatment, however, with an adequate response in growth correlated with the genetic height, the height at the beginning, the age of onset and the growth rate at the beginning of the treatment. Its important to optimize the treatment to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain, and achieve an adult height within the normal target range. Although a high dose of up to 0.067 mg/kg per day is relatively safe, adequate response to lower doses should be considered in the light of long-term comorbidities in these patients.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology