European Multicentre Study in Children Born Small for Gestational Age with Persistent Short Stature: Comparison of Continuous and Discontinuous Growth Hormone Treatment Regimens
Abstract
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.