Comparison of body surface area versus weight-based growth hormone dosing for girls with Turner syndrome.
OBJECTIVE
Growth Hormone (GH) dosage in childhood is adjusted for body size, but there is no consensus whether body weight (BW) or body surface area (BSA) should be used. We aimed at comparing the biological effect and cost-effectiveness of GH treatment dosed per m2 BSA in comparison with dosing per kg BW in girls with Turner syndrome (TS).


METHODS
Serum IGF-I, GH dose, and adult height gain (AHG) from girls participating in two Dutch and five Swedish studies on the efficacy of GH were analyzed, and the cumulative GH dose and costs were calculated for both dose adjustment methods. Additional medication included estrogens (if no spontaneous puberty occurred) and oxandrolone in some studies.


RESULTS
At each GH dose, the serum IGF-I standard deviation score remained stable over time after an initial increase after the start of treatment. On a high dose (at 1 m2 equivalent to 0.056-0.067 mg/kg/day), AHG was at least equal on GH dosed per m2 BSA compared with dosing per kg BW. The cumulative dose and cost were significantly lower if the GH dose was adjusted for m2 BSA.


CONCLUSIONS
Dosing GH per m2 BSA is at least as efficacious as dosing per kg BW, and is more cost-effective.
Centre for Human Drug Research, Leiden, The Netherlands.
Lenneke
L
Schrier
Marieke L
ML
de Kam
Rachel
R
McKinnon
Amalina
A
Che Bakri
Wilma
W
Oostdijk
Theo C J
TC
Sas
Leonie A
LA
Menke
Barto J
BJ
Otten
Sabine M P F
SM
de Muinck Keizer-Schrama
Berit
B
Kristrom
Carina
C
Ankarberg-Lindgren
Jacobus
J
Burggraaf
Kerstin
K
Albertsson-Wikland
Jan M
JM
Wit
D000293:Adolescent; D000328:Adult; D001830:Body Surface Area; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D054796:Drug Dosage Calculations; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D014424:Turner Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I