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Treatment with growth hormone‐releasing hormone (GHRH) 1–44 in children with idiopathic growth hormone deficiency: a randomized double‐blind dose‐effect study
Author(s) -
Lievre M.,
Chatelain P.,
Vliet G.,
Olivier M.,
Blanchard J.,
Morre M.,
Boissel JP
Publication year - 1992
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1111/j.1472-8206.1992.tb00131.x
Subject(s) - bone age , medicine , percentile , placebo , evening , growth hormone deficiency , endocrinology , growth hormone–releasing hormone , hormone , growth hormone treatment , adverse effect , growth hormone , mathematics , statistics , physics , alternative medicine , pathology , astronomy
Summary— One hundred and eleven pre‐pubertal children (70 boys, 41 girls, aged 2.5 to 14.3 years) with growth failure (height 2 SD below the mean for chronological age (CA) and height velocity (HV) below the 10th percentile for bone age) due to idiopathic growth hormone deficiency (peak plasma GH < 20 mUI/1 to two standard provocative tests) were treated with GHRH 1–44 NH2. Patient stratification in two classes was performed according to body weight; in each class, patients were randomly allocated to one of seven GHRH doses, from 30 to 300 μg/day. GHRH was injected subcutaneously, every evening, for six months in a double‐blind fashion. No relationship was found between the absolute or incremental HV during treatment and the dose (range from 1.3 – 23.1 μg/kg/day) of GHRH. However, HV (cm/year) increased from 3.8 ± 0.1 (mean ± SEM) before treatment to 6 ± 0.2 during six months treatment and 47 patients (42%) increased their HV up to at least the mean normal HV for bone age (catch‐up growth). Low titer antibodies to GHRH were found in 19 patients (17.1%) at six months; no adverse effect was observed. Our results suggest that patients showing catch‐up growth were older, had a height closer to the mean for chronological age and a slower pre‐treatment height velocity. Failure to demonstrate a relationship between GHRH dose and changes in growth velocity might be explained by the combination of a placebo effect, insufficient frequency of GHRH administration and heterogeneity of the population.