title: Indications for growth hormone therapy in children.
abstract: Growth hormone (GH) therapy has now been available for over 5 decades, with all GH now biosynthetically produced, and administered by daily injection. Paediatric GH is currently licensed in six different conditions: growth hormone deficiency (GHD), Turner syndrome (TS), small for gestational age (SGA), Prader-Willi-syndrome (PWS), chronic renal insufficiency (CRI), and short stature due to SHOX deficiency; all of these have been ratified by the most recent (2010) NICE review. Whilst the primary purpose of paediatric GH therapy in most indications is to improve short and long-term growth, in others (eg. PWS) it has a role in improvement of body composition. Recent UK national audits indicate approximately 4700 children receiving GH therapy, with approximately 760 new starts a year, with most prescription still via historical growth centres. There are currently 7 different manufacturers of GH, and while most UK units currently offer free patient choice for GH device, with preliminary evidence indicating that this may improve adherence with therapy, the 30% price difference may limit choice in the future.
authors.affiliation: Department of Endocrinology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK. jeremy.kirk@bch.nhs.uk
authors.forename: Jeremy
authors.initials: J
authors.lastname: Kirk
mesh_terms: D002648:Child; D004334:Drug Administration Schedule; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D018398:Homeodomain Proteins / Q000235:genetics; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D056687:Off-Label Use; D011218:Prader-Willi Syndrome / Q000188:drug therapy; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000150:complications; D000074122:Short Stature Homeobox Protein; D014424:Turner Syndrome / Q000188:drug therapy
chemical_list: D018398:Homeodomain Proteins; D011994:Recombinant Proteins; C106071:SHOX protein, human; D000074122:Short Stature Homeobox Protein; D019382:Human Growth Hormone