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Hormone replacement therapy in children: The use of growth hormone and IGF-I
- Source :
- Best Practice & Research Clinical Endocrinology & Metabolism. 29:339-352
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Recombinant human GH (rhGH) has been available since 1985. This article gives an overview, what has been achieved over the past 30 years in respect to optimization of rhGH treatment for the individual child with GH deficiency and what are the safety issues concerned with this treatment. In the last twenty years significant scientific progress has been made in the diagnosis of GH deficiency, the genetic disorders that are associated with pituitary GH deficiency and the genetics that influence growth in general. On the other hand rhGH is not only used in states of GH deficiency but also various conditions without a proven GH deficiency by classical standards. Clinical studies that investigated both the genetics of growth and the individual responses to rhGH therapy in these patient populations were able to refine our concept about the physiology of normal growth. In most patients under rhGH treatment there is a considerable short-term effect, however the overall gain in growth obtained by a long-term treatment until final height still remains a matter of debate in some of the conditions treated. Also first studies on the long-term safety risks of rhGH treatment have raised the question whether this treatment is similarly safe for all the patient groups eligible for such a treatment. Therefore even in the face of a longstanding safety record of this drug replacement therapy the discussion about the right cost and risk to benefit ratio is continuing. Consequently there is still a need for carefully conducted long-term studies that use modern anthropometric, genetic, and laboratory techniques in order to provide the necessary information for clinicians to select the patients that will benefit best from this valuable treatment without any long term risk.
- Subjects :
- Pediatrics
medicine.medical_specialty
Hormone Replacement Therapy
Endocrinology, Diabetes and Metabolism
Turner Syndrome
Rhgh treatment
Growth hormone
Growth hormone deficiency
Endocrinology
medicine
Growth Hormone Insensitivity Syndrome
Humans
Hormone replacement therapy
Insulin-Like Growth Factor I
Child
Dwarfism, Pituitary
Growth Disorders
Human Growth Hormone
business.industry
Noonan Syndrome
Infant, Newborn
medicine.disease
Recombinant Proteins
Idiopathic short stature
Infant, Small for Gestational Age
Normal growth
Kidney Failure, Chronic
business
Prader-Willi Syndrome
GH Deficiency
Subjects
Details
- ISSN :
- 1521690X
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Best Practice & Research Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....9cfbb2396a967afac436600e08ee6b6a