title: Impact of age and duration of growth hormone therapy in children with Turner syndrome.
abstract: OBJECTIVE
  To assess height standard deviation scores (HSDS) in patients with Turner syndrome (TS) by age at treatment initiation and varying durations of treatment with growth hormone (GH).
  
  
  METHODS
  GH treatment-naïve patients with TS from the American Norditropin Studies: Web-enabled Research (ANSWER) Program® Registry were analyzed at baseline, 4 months, and annually.
  
  
  RESULTS
  Three hundred and eighty-two patients with TS had a baseline mean (±SD) HSDS of -2.6 ± 0.9. Patients received short-term (1 year), long-term (<3 years), and extended GH treatment (≥3 years, mean = 4.54 years), resulting in 40.2% (n = 99/246), 60.5% (n = 69/114), and 62.3% (n = 86/138) of the patients achieving HSDS >-2. Patients starting GH at a younger age experienced better growth response, regardless of treatment duration. Change in HSDS from baseline (ΔHSDS) at 4 months correlated positively with ΔHSDS at 1 and 3 years, and ΔHSDS at 1 year with ΔHSDS at 3 years (p values from 0.0017 to<0.0001).
  
  
  CONCLUSIONS
  Height gains in patients with TS during short-term treatment were found to be highly predictive of longer-term results. Continuation of GH treatment (≥3 years) resulted in 62.3% of the patients achieving an HSDS within the normal population range, indicating the clinical importance of early initiation and continuation of GH treatment in patients with TS.
authors.affiliation: Department of Pediatrics, Thomas Jefferson University DuPont Hospital for Children, Philadelphia, Pa., USA. judith.ross@jefferson.edu
authors.forename: Judith
authors.initials: J
authors.lastname: Ross
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lee
authors.forename: Robert
authors.initials: R
authors.lastname: Gut
authors.forename: John
authors.initials: J
authors.lastname: Germak
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000187:drug effects; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D057286:Electronic Health Records; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000517:prevention & control*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012042:Registries; D012720:Severity of Illness Index; D014424:Turner Syndrome / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone