GROWTH-HORMONE THERAPY FOR 3 YEARS - THE OZGROW EXPERIENCE

Objective: To examine the growth response over 3 years of growth hormo ne deficient (GHD) and non-GHD children who have received growth hormo ne (GH) in Australia. Methodology: A retrospective study of a group of patients (1362 children) who commenced GH prior to 1 September 1990. Data were collected at 12 growth centres located in major cities throu ghout Australia. The data were transferred after informed consent to t he national OZGROW database located at the Royal Alexandra Hospital fo r Children, Sydney, NSW. Of the 1362 children, 898 had received 3 year s or more GH therapy and were eligible for this analysis. This cohort was then categorized by diagnosis. Growth response was assessed using height standard deviation score, estimated mature height, growth veloc ity (GV), GH dose and bone age (years). Results: For children who comp leted 3 years therapy, the baseline characteristics among diagnostic g roups were similar with mean height standard deviation score (SDS) les s than -3 SDS (except for the malignancy group) and mean GV ranging fr om 3.5 to 4.4 cm/year. The GV during the first year improved in all gr oups (7.7-9.4 cm/year) followed by an attenuated response during the s econd and third years of therapy. After 3 years GH therapy the GHD gro up with peak levels <10 mU/L demonstrated the greatest change in estim ated mature height and height SDS. The GHD group with peak levels betw een greater than or equal to 10 but <20 mU/L had a growth response sim ilar to the non-GHD children for all outcome parameters. Change in bon e age ranged from 3.1 to 3.8 years with no differences being noted bet ween the diagnostic groups, nor consistently with pubertal status. Con clusions: Australian GH guidelines have targeted very short children w hen compared to other series. This large cohort of non-GHD children ha s demonstrated short-term benefits of GH therapy; however, the long-te rm benefit remains unclear until these children reach final adult heig ht.