The Pharmaceutical Journal
Vol 269 No 7207 p90
20 July 2002

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BMJ (bmj.com)

Benefits of long-term growth hormone are unclear

Benefits of long-term treatment with growth hormone are unclear and data only support treatment of patients with severely and permanently altered growth hormone secretion, a study published in the BMJ shows. However, the study is criticised for not taking into account that the subjects received too little growth hormone too late.

Researchers looked retrospectively at 2,852 children diagnosed with isolated idiopathic growth hormone deficiency who had been treated with growth hormone. Change in height between the start of treatment and adulthood was measured. The researchers found that the effects of growth hormone were unclear in many patients and that most had pubertal delay with a potential for spontaneous catch up.

The researchers recommend that the diagnosis of idiopathic growth hormone deficiency should be restricted to those with peak growth hormone values below 2–4µg/L, that sex steroid priming is used before growth hormone testing and that more attention is paid to the causes of hypopituitarism (2002;325:70).

However, in an accompanying editorial (ibid, p58), Professor Paul Saenger, Albert Einstein College of Medicine, New York, says: "The overly pessimistic conclusion that growth hormone therapy is inappropriate in most children so treated does not take into account that patients were older and that they were treated for too short a time."

Guidance issued in May by the National Institute for Clinical Excellence endorses growth hormone as a clinically- and cost-effective way to treat children with growth hormone deficiency (PJ, 1 June, p754).