OPTIMIZING GROWTH-HORMONE THERAPY DURING PUBERTY

During puberty, growth hormone (GH)-deficient children may experience difficulties achieving an appropriate pubertal growth spurt. We review the complex hormonal interactions which occur during puberty. At leas t two therapeutic strategies have been developed to optimize GH therap y during puberty. In the first strategy, the GH dose administered per kilogram of body weight is increased during puberty, in an attempt to mimic the physiological increase of GH which occurs during puberty. In the second strategy, luteinizing hormone-releasing hormone (LHRH) ana logs are administered concomitantly with GH with the aim of delaying e piphyseal fusion. The efficacy of these strategies to increase final h eight has not previously been clearly demonstrated.