A COMPARATIVE-STUDY OF GROWTH-HORMONE (GH) AND GH-RELEASING HORMONE(1-29)-NH2 FOR STIMULATION OF GROWTH IN CHILDREN WITH GH DEFICIENCY

In this study, 60 patients with proven growth hormone deficiency (GHD) of hypothalamic origin were randomized into three equal groups, and r eceived growth hormone-releasing hormone(1-29)-NH2 (GHRH(1-29)-NH2), 3 0 or 60 mug/kg/day, or growth hormone (GH), 0.1 IU/kg/day, for 6 month s. There were no significant differences in growth between the two gro ups given GHRH(1-29)-NH2, but growth in the GH group was significantly better than in the other two groups (p < 0.01). Mean height velocitie s at 6 months were 9.2, 9.3 and 14.6 cm/year for the three groups, res pectively. Plasma GHRH concentrations increased steadily over the 6-mo nth treatment period, with higher levels in the group on the higher do se. During GHRH(1-29)-NH2 treatment, serum concentrations of insulin-l ike growth factor I rose initially, but then fell to values similar to those before treatment. No GH antibodies were detected, but all 20 pa tients on high-dose GHRH(1-29)-NH2 and 19 of 20 patients on low-dose G HRH(1-29)-NH2 developed GHRH antibodies. These had almost disappeared by 9 months after stopping treatment. There was no correlation between antibody titres and increase in height. No serious side-effects were seen, but three patients receiving GHRH(1-29)-NH2 reported mild irrita tion at the injection site. These results from the continuous infusion of GHRH(1-29)-NH2 over 6 months suggest that this treatment, or the r elated use of a depot preparation, is unlikely to be as effective as G H for the promotion of growth in GHD.