Endocrine Abstracts

JOINT2803

Aim: Growth hormone (GH) therapy is an effective therapeutic modality for children with GH insufficiency. However, in some cases, treatment may yield inadequate responses, limiting the attainment of intended outcomes. Retrospective studies suggest that numerous factors affect the efficacy of GH treatment. The dosage of growth hormone is a critical component influencing growth response. Consequently, if the growth response is suboptimal in the initial year, it is advisable to augment the GH treatment dosage in the guidelines. This study presents the implementation outcomes of the technique indicated in the guidelines.

Material and methods: The study comprised a total of 163 diagnosed instances of GH deficiency. Growth hormone treatment commenced in the instances at a dosage of 25-35 mg per day. During the initial year of treatment, children with mild growth hormone (GH) insufficiency (peak GH between 5-10 ng/dL in stimulation tests) exhibit a 0. 3 standard deviation score (SDS), while those with severe GH deficiency (peak GH <5 ng/mL in stimulation tests) show a 0. 4 SDS. A 100% rise was deemed a sufficient treatment response (Group 1), whereas its absence was regarded as an insufficient response (Group 2). In the inadequately responding cohort, the GH dosage was escalated by 20% per kilogram prior to the second year, and the patients’ growth velocities and IGF-1 concentrations were assessed over a period of 3 years.

Results: During the initial year of treatment, it was noted that the height SDS increase was inadequate in 53 out of 163 patients (32. 5%). Both Group 1 and Group 2 had three years of treatment. Table 1 presents the GH doses, height SDS values, IGF-1 SDS values, and alterations in height SDS values from the commencement to the conclusion of treatment for each year. Following the dosage augmentation, growth in Group 2 intensified, and at the conclusion of the third year, overall height rise neared that of Group 1. At the conclusion of the second year, the dosage was necessitated to be reduced in 20 patients from the good response cohort and in 6 patients from the poor response cohort due to elevated IGF-1 SDS values.

Conclusion: In the management of GH insufficiency, monitoring treatment response and adjusting dosages appropriately enhances therapeutic success and provides the individual with an opportunity for growth comparable to those who have a favorable response.