Growth and Adult Height in Girls With Turner Syndrome Following IGF-1 Titrated Growth Hormone Treatment
| Autor: | Casper P. Hagen, Rikke Beck Jensen, Leila Nedaeifard, Amanda Cleemann Wang, Anders Juul |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Adolescent Endocrinology Diabetes and Metabolism Clinical Biochemistry Karyotype Turner Syndrome 030209 endocrinology & metabolism Context (language use) Growth hormone Biochemistry 03 medical and health sciences 0302 clinical medicine Endocrinology Interquartile range Reference Values Internal medicine Turner syndrome Medicine Humans Drug Dosage Calculations 030212 general & internal medicine Dosing Longitudinal Studies Insulin-Like Growth Factor I Child Retrospective Studies Dose-Response Relationship Drug business.industry Human Growth Hormone Biochemistry (medical) medicine.disease Adult height Body Height Growth hormone treatment Treatment Outcome Karyotyping Cohort Female business |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 105(8) |
| ISSN: | 1945-7197 |
| Popis: | Context Girls with Turner syndrome (TS) suffer linear growth failure, and TS is a registered indication for growth hormone (GH) treatment. GH is classically dosed according to body weight, and serum insulin-like growth factor-1 (IGF-1) concentrations are recommended to be kept within references according to international guidelines. Objective To assess the effect of long-term GH treatment in girls with TS following GH dosing by IGF-1 titration. Design and setting A retrospective, real-world evidence, observational study consisting of data collected in a single tertiary center from 1991 to 2018. Patients A cohort of 63 girls with TS treated with GH by IGF-1 titration with a median duration of 6.7 years (interquartile range [IQR]: 3.4-9.7 years). Main outcome measures Longitudinal measurements of height, IGF-1, and adult height (AH) following GH treatment were evaluated and compared between the different karyotypes (45,X, 45,X/46,XX, or miscellaneous). Results Using GH dose titration according to IGF-1, only 6% of girls with TS had supranormal IGF-1 levels. Median dose was 33 µg/kg/day (IQR: 28-39 µg/kg/day) with no difference between the karyotype groups. AH was reached for 73% who attained a median AH of 1.25 standard deviation score (SDS) for age specific TS references (IQR: 0.64-1.50 SDS), and a median gain in height (ΔHSDS: AH SDS minus baseline height SDS of TS references) of 0.50 SDS, equal to 3.2 cm (SD 7.68) for all karyotypes. Conclusion Our real-world evidence study suggested that titration of GH dose to keep IGF-1 levels within the normal range resulted in a lower AH gain than in studies where a fixed dose was used. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|