Abstract
We have compared subcutaneous (s.c.) pulsed administration of hGH 0.6 IU 3 hourly at night with hGH 2 IU administered s.c. and 4 ID administered i.m. in 6 GH deficient children aged 5.9-11.6 years. Five had received hGH 4 IU i.m. for 3.6 years (range 2.5-4). Each of these children and one new patient received hGH 2 IU s.c. and 0.6 IU 3 times each night via a mini infusion pump for 6 months in random order. Serum GH profiles were obtained on all treatment regimens.
Peak GH concentrations and areas under the GH curves were dose related. The time to attain the GH peaks was similar using i.m. (3.6h) or s.c. (3.9h) routes. A single injection did not mimic physiological GH pulses but these were more closely attained using pulsed administration.
Four children completed the entire study; 3 grew equally at all times but height velocity fell in one on the pulsed regimen. Following cessation of all GH treatment, mean height velocity SDS (−4.0) was significantly lower than before all treatments (−2.1).
Pulsatile hGH administration is effective but had no significant advantage. A post treatment velocity must not be used to measure the effects of a treatment.
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Brook, C., Pringle, P. & Smith, P. SINGLE AND MULTIPLE PULSES OF GROWTH HORMONE (GH) IN THE TREATMENT OF GH DEFICIENCY. Pediatr Res 20, 1187 (1986). https://doi.org/10.1203/00006450-198611000-00079
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DOI: https://doi.org/10.1203/00006450-198611000-00079