ESPE Abstracts (2014) 82 P-D-3-2-849

GH Therapy in Prepubertal Children: Results After 4 Years

Corina Galesanua, Andra Iulia Loghina, Ilinka Grozavua, Luminita Apostua, Didona Ungureanua & Mihail Romeo Galesanub

aUniversity of Medicine and Pharmacy, Iasi, Romania; bRomanian Academy of Medical Sciences, Iasi, Romania

Background: GH therapy is being used worldwide to improve height outcome in children with GH deficiency (GHD), with minimal serious side effects. Early diagnosis and therapy initiation optimize growth outcomes.

Objectives: To evaluate growth and safety during the first 4 years of GH treatment in 33 GHD children.

Methods: We reviewed clinical data of 33 prepubertal children (23 boys and ten girls): 30 with isolated GH deficiency (IGHD), three with multiple pituitary hormone deficiency (MPHD). All of them were treated with a mean dose of GH=0.035 mg/kg per day and followed for at least 4 years (mean 5.98 years).

Results: The mean height SDS increased from −2.76 at baseline to −0.73 at 4 years; the change in height SDS decreased with time Table 1. Within first 4 years of therapy none of these children developed diabetes mellitus, seven patients (21.21%) presented transient increase in fasting glucose (>100 <126 mg/dl), two patients (6.06%) had transiently impaired glucose tolerance (<140 <200 mg/dl at OGTT), three patients (9.09%) developed hypothyroidism and one patient (3.03%) had transiently increased TSH levels (normal fT4 values, no clinical signs). No malignancies were observed to date.

Table 1. Growth data during first 4 years of GH therapy in 33 GHD children.
ParameterBaseline1 year2 years3 years4 years
Chronological age (years)7.898.899.8910.8911.89
Bone age (years)5.766.627.449.4611.07
IGF-1 mean values (ng/ml)64.64221.8205.7265338
Height SDS−2.76−2.12−1.55−1.14−0.73
Height velocity (cm/year)10.597.486.046.76
Weight SDS−1.94−1.28−0.94−0.46−0.12

Conclusions: GH treatment significantly improves growth of GHD children, with a favorable safety profile. The maximum height velocity was observed in the first year of therapy (10.59 cm/year); the following years of treatment resulted in a lower height velocity (7.48 cm/year, 6.04 cm/year, 6.76 cm/year respectively). No severe adverse events were observed.

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