The effect of growth hormone treatment on final height: What do we know?

The current adult heights of hypopituitary children treated with recombinan t human growth hormone (rGH) now range between -1.5 to -0.7 height SD score s (Ht SDS) of control populations. These height outcomes are markedly bette r than those observed after treatment with pituitary derived human growth h ormone (-4.7 to -2.0 Ht SDS). Although treatment with rGH has not yielded a dult heights that are equal to genetic target heights, the discrepancy is m uch less now than in previous decades. Higher rGH dose, longer duration of treatment, early age at diagnosis, correction of height deficit before onse t of puberty, and daily rGH injections have had beneficial effects on final adult heights. The current dosing regimens (0.3 to 0.18 mg/kg/week) have n ot had an adverse effect on bone maturation and have not stimulated an earl ier onset of puberty. Although height gains in puberty are less than contro ls, a majority of treated subjects reach heights within the normal range fo r adults. Higher doses of rGH during puberty have been studied in limited n umbers of adolescents with positive effects; however, standard dosing will likely continue to be used because of financial considerations and safety c oncerns. Further improvements in adult heights are likely to be reported wh en the youngest children who began rGH in 1985 complete their growth.