Biosynthetic human growth hormone: current status and future questions.
Human growth hormone derived from human pituitaries resulted in excellent growth in children with growth hormone deficiency but limited supplies in many countries prevented treatment of all children, delayed the onset of therapy, and/or forced the use of doses that may have been less than optimal. Recent advances in technology allow the production of byosynthetic human growth hormone (hGH) by recombinant methods resulting in increased supplies of hormone. More than 200 previously untreated children with growth hormone deficiency have been evaluated for two years or longer while receiving biosynthetic natural sequence hGH (somatropin). The mean growth velocity of 3.6 cm/yr prior to therapy increased to 8.8 cm/yr after one year and 7.25 cm/yr in the second year. Growth response was inversely related to age when calculated as cm/yr. This response paralleled the normal decrease in growth velocity as children approach puberty. Children with hGH deficiency who had previously received replacement hGH were enrolled in a double-blind study using either 0.06 or 0.10 mg/kg thrice weekly for 12 months. Growth rate was significantly greater with the higher dose during the first six months but not during the second six month period. The use of a higher dose of hGH must be individualized as not all patients have accelerated growth with the increased dose and the mean group response is not permanent. Multiple questions remain unanswered after three decades of treating growth hormone deficiency. Are the current criteria for diagnosis of growth hormone deficiency appropriate? What dose of hGH is correct? Do children need increases in replacement therapy as their height approaches normal?(ABSTRACT TRUNCATED AT 250 WORDS)
Thompson
R G
RG
Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana 46285.
Conforti
P
P
Holcombe
J
J
D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy*; D013006:Growth Hormone / Q000096:biosynthesis / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000096:biosynthesis / Q000627:therapeutic use*
D011994:Recombinant Proteins; D013006:Growth Hormone