Pediatric growth hormone therapy in Greece: analysis of the Hellenic cohort of the GeNeSIS study

Effect of Growth Hormone Treatment on Growth Rates in Patients With Growth Hormone Deficiency, Idiopathic Short Stature, and Small for Gestational Age

OBJECTIVE

This study aimed to determine the response to growth hormone (GH) therapy of patients with growth hormone deficiency (GHD), idiopathic short stature (ISS), and small for gestational age (SGA).

MATERIALS AND METHODS

The data of the 202 children who received GH treatment were analyzed retrospectively. Laboratory parameters, puberty stages, annual growth rates, body mass index (BMI), GH side effects, target height (TH), estimated adult height (EAH), and bone age (BA) were obtained during the GH treatment period.

RESULTS

Out of 202 cases, 121 were girls (59.9%) and 81 were boys. Among these cases, 69 (34.1%) had partial growth hormone deficiency (PGHD), 43 (21.2%) had complete growth hormone deficiency (CGHD), 37 (18.3%) had ISS, and 53 (26.2%) were born SGA. The average age at the onset of treatment was 11.2±2.67 years. The height standard deviation score (SDS), height velocity, and predicted adult height (PAH) of the patients with PGHD, CGHD, and SGA values were significantly higher than ISS patients at the end of the third year of a similar dose of GH treatment. The highest growth velocity was determined in the group with CGHD, while the lowest height velocity was found in patients with ISS during three years of the treatment.

CONCLUSION

It was determined that GH treatment is an efficient and reliable therapy method for improving short stature in patients with PGHD, CGHD, ISS, and SGA. We observed a higher growth rate in patients with PGHD, CGHD, and SGA than in the ISS group with standard dose GH treatment.

Evaluation of Growth Hormone Results in Different Diagnosis and Trend Over 10 Year of Follow-up: A Single Center Experience

OBJECTIVE

The aim was to evaluate the results of diagnosis, follow-up and treatment of the patients who recieved growth hormone (GH) treatment for the last 10 years and to determine the differences in the process and results over the years.

METHODS

Anthropometric, clinical, laboratory data, treatment adherence and side effects were evaluated retrospectively in 767 patients who recieved GH treatment between 2009-2018. Patients were grouped as isolated GH deficiency (IGHD), multiple pituitary hormone deficiency (MPHD), small for gestational age (SGA), and Turner syndrome (TS) depending on diagnosis.

RESULTS

GH treatment was started in 689 cases (89.8%) with IGHD, 24 (3.1%) with MPHD, 26 (3.4%) with SGA and 28 (3.7%) with TS. Median age of GH treatment onset was the earliest in SGA (8.4 years) and the latest in the IGHD group (12.0 years). At the time of treatment cessation, height standard deviation score (SDS) in IGHD and MPHD was significantly higher than treatment initiation time, whereas there was no significant difference in TS and SGA. One hundred eighty-nine cases reached the final height. Final heights for girls/boys were: IGHD 154/164.9 cm; MPHD 156.2/163.5 cm; TS 146.7 cm; and SGA 145.7/-cm, respectively. Target height SDS-final height SDS median values were IGHD: 0.1, MPHD: 0.6, SGA: 0.5, TS: 2.4 respectively. The patients’ treatment compliance was high (92%) and the incidence of side effects was low (2.7%).

CONCLUSION

In our cohort, GH treatment start age was late and no difference in this was observed in the last 10 years. The improvement in the height SDS was most marked in the IGHD and MPHD groups, the least in the TS and SGA groups.