title: Towards optimal treatment with growth hormone in short children and adolescents: evidence and theses.
abstract: Treatment with growth hormone (GH) has become standard practice for replacement in GH-deficient children or pharmacotherapy in a variety of disorders with short stature. However, even today, the reported adult heights achieved often remain below the normal range. In addition, the treatment is expensive and may be associated with long-term risks. Thus, a discussion of the factors relevant for achieving an optimal individual outcome in terms of growth, costs, and risks is required. In the present review, the heterogenous approaches of treatment with GH are discussed, considering the parameters available for an evaluation of the short- and long-term outcomes at different stages of treatment. This discourse introduces the potential of the newly emerging prediction algorithms in comparison to other more conventional approaches for the planning and evaluation of the response to GH. In rare disorders such as those with short stature, treatment decisions cannot easily be deduced from personal experience. An interactive approach utilizing the derived experience from large cohorts for the evaluation of the individual patient and the required decision-making may facilitate the use of GH. Such an approach should also lead to avoiding unnecessary long-term treatment in unresponsive individuals.
authors: Paediatric Endocrinology Section, Children's Hospital, University of Tuebingen, Tuebingen, Germany. Michael.Ranke@med.uni-tuebingen.de
authors: Michael B
authors: MB
authors: Ranke
authors: Anders
authors: A
authors: Lindberg
authors: Primus E
authors: PE
authors: Mullis
authors: Mitchell E
authors: ME
authors: Geffner
authors: Toshi
authors: T
authors: Tanaka
authors: Wayne S
authors: WS
authors: Cutfield
authors: Maïthé
authors: M
authors: Tauber
authors: David
authors: D
authors: Dunger
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male
chemical_list: D019382:Human Growth Hormone