title: 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.
abstract: BACKGROUND
  Weight-based GH dosing results in a wide variation in growth response in children with GH deficiency (GHD) or idiopathic short stature (ISS).
  
  
  OBJECTIVE
  The hypothesis tested was whether individualized GH doses, based on variation in GH responsiveness estimated by a prediction model, reduced variability in growth response around a set height target compared with a standardized weight-based dose.
  
  
  METHODS
  A total of 153 short prepubertal children diagnosed with isolated GHD or ISS (n = 43) and at least 1 SD score (SDS) below midparental height SDS (MPH(SDS)) were included in this 2-yr multicenter study.
  
  
  METHODS
  The children were randomized to either a standard (43 microg/kg.d) or individualized (17-100 microg/kg.d) GH dose.
  
  
  METHODS
  We measured the deviation of height(SDS) from individual MPH(SDS) (diffMPH(SDS)). The primary endpoint was the difference in the range of diffMPH(SDS) between the two groups.
  
  
  RESULTS
  The diffMPH(SDS) range was reduced by 32% in the individualized-dose group relative to the standard-dose group (P < 0.003), whereas the mean diffMPH(SDS) was equal: -0.42 +/- 0.46 and -0.48 +/- 0.67, respectively. Gain in height(SDS) 0-2 yr was equal for the GH-deficient and ISS groups: 1.31 +/- 0.47 and 1.36 +/- 0.47, respectively, when ISS was classified on the basis of maximum GH peak on the arginine-insulin tolerance test or 24-h profile.
  
  
  CONCLUSIONS
  Individualized GH doses during catch-up growth significantly reduce the proportion of unexpectedly good and poor responders around a predefined individual growth target and result in equal growth responses in children with GHD and ISS.
authors.affiliation: Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Science, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.
authors.forename: Berit
authors.initials: B
authors.lastname: Kriström
authors.forename: A Stefan
authors.initials: AS
authors.lastname: Aronson
authors.forename: Jovanna
authors.initials: J
authors.lastname: Dahlgren
authors.forename: Jan
authors.initials: J
authors.lastname: Gustafsson
authors.forename: Maria
authors.initials: M
authors.lastname: Halldin
authors.forename: Sten A
authors.initials: SA
authors.lastname: Ivarsson
authors.forename: Nils-Osten
authors.initials: NO
authors.lastname: Nilsson
authors.forename: Johan
authors.initials: J
authors.lastname: Svensson
authors.forename: Torsten
authors.initials: T
authors.lastname: Tuvemo
authors.forename: Kerstin
authors.initials: K
authors.lastname: Albertsson-Wikland
mesh_terms: D054316:Biomarkers, Pharmacological / Q000032:analysis; D001827:Body Height / Q000187:drug effects; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods; D004393:Dwarfism, Pituitary / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000503:physiopathology; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency; D006801:Humans; D007206:Individuality; D008297:Male; D010290:Parents; D011153:Population; D011627:Puberty / Q000187:drug effects; D012727:Sex Characteristics
chemical_list: D054316:Biomarkers, Pharmacological; D019382:Human Growth Hormone