European multicentre study in children born small for gestational age with persistent short stature: comparison of continuous and discontinuous growth hormone treatment regimens.
BACKGROUND
The most effective growth hormone (GH) treatment regimen for increasing height in short children born small for gestational age (SGA) has not been well defined.


METHODS
Short SGA children (n = 151, age 3-8 years, height less than -2.5 standard deviation scores) were randomised to receive low-dose GH for 2 years (0.033/0.033 mg/kg/day, n = 51), high-dose GH for 1 year and then no treatment for 1 year (0.100/0 mg/kg/day, n = 51) or were untreated for 1 year then received mid-dose GH for 1 year (0/0.067 mg/kg/day, n = 47). Height, bone age and adverse events were determined at check-ups every 3 months.


RESULTS
The mean +/- SD additional height gain with GH after 1 year, relative to untreated controls, was higher with discontinuous high-dose than with continuous low-dose GH (6.5 +/- 0.2 vs. 3.3 +/- 0.2 cm). After 2 years, the additional height gain was similar between high- and low-dose GH groups (between-group treatment difference = 0.2, 95% CI = -0.8 to 1.2 cm, p = 0.702). Patients treated exclusively in the last year had a similar height gain to those in the other treatment groups (p = 0.604).


CONCLUSIONS
In short SGA children, continuous low-dose and discontinuous high-dose GH regimens were associated with similar height gain. Treatment with mid-dose GH for 1 year also led to a similar improvement in growth.
Phillip
Moshe
M
Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. mosheph@post.tau.ac.il
Lebenthal
Yael
Y
Lebl
Jan
J
Zuckerman-Levin
Nehama
N
Korpal-Szczyrska
Maria
M
Marques
Jorge Sales
JS
Steensberg
Adam
A
Jons
Kirsten
K
Kappelgaard
Anne-Marie
AM
Ibanez
Lourdes
L
D001786:Blood Glucose / Q000378:metabolism; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007279:Injections, Subcutaneous; D007328:Insulin / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I; C515497:IGFBP3 protein, human