Treatment

Recombinant human growth hormone (rhGH), also known as somatropin, has dramatically improved the treatment of GHD. Early diagnosis and treatment enables normal growth to proceed.

Patients are treated with subcutaneous rhGH given at bedtime. Subsequent rapid short-term growth is followed by normalisation of long-term growth. Treatment should be continued until final height or epiphyseal closure is achieved. (1,2)

Treatment is with synthetic human growth hormone, although other additional hormones may also be indicated.

Treatment with growth hormone in a child with growth hormone deficiency should be started as soon as possible after diagnosis.

There is evidence that treatment with synthetic growth hormone in a children with growth hormone deficiency:

• produces a final height gain of 25-30cm (3)
• almost 90% of children with growth hormone deficiency treated with synthetic growth hormone achieve an adult final height within the genetically determined target height range (4)

References:

1. Grimberg A et al. 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. Horm Res Paediatr. 2016;86(6):361-97.
2. Rappaport R et al; French Serono Study Group. A 5-year prospective study of growth hormone (GH)-deficient children treated with GH before the age of 3 years. J Clin Endocrinol Metab. 1997 Feb;82(2):452-6.
3. The British Society for Paediatric Endocrinology and Diabetes and the Royal Colleges of Paediatrics and Child Health. Submission of evidence for the National Institute of Clinical Excellence health technology appraisal: the use of human growth hormone in children. 2002.
4. Thomas M et al. Final height in children with idiopathic growth hormone deficiency treated with recombinant human growth hormone: the Belgium experience. Horm Res 2001; 55:88-94