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Submitted on March 31, 2008
Accepted on August 15, 2008
Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg (K.A-W., B.K., O.W.), SE-41685 Gothenburg; Department of Pediatrics, The Central County Hospital of Halmstad (A.S.A.), SE-30185 Halmstad; Department of Women's and Children's Health, Uppsala University (J.G., B.J., T.T.), SE-75185 Uppsala; Department of Woman and Child Health, Karolinska Institutet (L.H., E.M.R.), SE-17176 Stockholm; Department of Clinical Sciences, University Hospital Malmö, Lund University (S.A.I., K.O.N.), SE-20502 Malmö; Department of Clinical Science, Paediatrics, Umeå University (B.K.), SE-90185 Umeå; Division of Pediatrics, Department for Clinical Science, Intervention and Technology, Karolinska Institutet (C.M.), SE-14186 Stockholm; Department of Pediatrics, Örebro University (J.A.), SE-70185 Örebro, Sweden
* To whom correspondence should be addressed. E-mail: kerstin.albertsson-wikland{at}pediat.gu.se.
Context: Effect of GH therapy in short non GH deficient children, especially idiopathic short stature (ISS) has not been clearly established owing to lack of controlled trials until final height (FH).
Objective: To investigate the effect of two GH doses compared with untreated controls on growth to FH in short children mainly with ISS.
Design and Setting: A randomized, controlled, long-term multicenter trial in Sweden.
Intervention: Two doses of GH (Genotropin): 33 or 67 µg/kg/d plus untreated controls.
Subjects: 177 subjects with short stature were enrolled. Of these, 151 were included in the Intent to Treat (AllITT) Population and 108 in the Per Protocol (AllPP) Population. Analysis of ISS subjects included 126 children in the ITT (ISSITT) Population and 68 subjects in the PP (ISSPP) Population.
Main Outcome Measures: FH SDS, difference in SDS to midparenteral height (diff MPHSDS), and gain in HeightSDS.
Results: After 5.9±1.1 yr on GH therapy, the FHSDS in the AllPP Population treated with GH vs. controls was -1.5±0.81 (33 µg/kg/d: -1.7±0.70, 67 µg/kg/d: -1.4±0.86; P<0.032), vs. -2.4±0.85 (P<0.001), the diff MPHSDS -0.2±1.0 vs. -1.0±0.74 (P<0.001), and the gain in HeightSDS 1.3±0.78 vs. 0.2±0.69 (P<0.001). GH therapy was safe and had no impact on time to onset of puberty. A dose-response relationship identified after 1 yr remained to FH for all growth outcome variables in all four populations.
Conclusion: GH treatment significantly increased FH in ISS children in a dose-dependent manner, with a mean gain of 1.3 SDS (8 cm), and a broad range of response from no gain to 3 SDS compared to a mean gain of 0.2 SDS in the untreated controls.
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  B. Kristrom, A. S. Aronson, J. Dahlgren, J. Gustafsson, M. Halldin, S. A. Ivarsson, N.-O. Nilsson, J. Svensson, T. Tuvemo, and K. Albertsson-Wikland Growth Hormone (GH) Dosing during Catch-Up Growth Guided by Individual Responsiveness Decreases Growth Response Variability in Prepubertal Children with GH Deficiency or Idiopathic Short Stature J. Clin. Endocrinol. Metab., February 1, 2009; 94(2): 483 - 490. [Abstract] [Full Text] [PDF]
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