Increased growth rate following transfer to daily sc administration from three weekly im injections of hGH in growth hormone deficient children

Abstract

The effect of more frequent (daily) injections of human growth hormoen (hGH) on growth rate was studied in 16 growth hormone deficient children (12 boys, 4 girls) during 2 yr. All had previously been treated with i.m. injection of hGH 2-3 times weekly and in the majority of the patients a waning growth response was observed. For a total weekly dose of 12 IU hGH a daily dose of 2 IU was injected s.c. at night before sleep. This dosage has been shown to imitate the average nocturnal hGH profile in plasma. Growth response on the i.m. treatment was 5.2 .+-. 1.2 cm/yr (SD) in boys and 5.4 .+-. 0.9 cm/yr in girls. A significant increase was seen during the 1st yr of s.c. treatment of 7.9 .+-. 2.7 cm in boys and 6.3 .+-. 2 cm in girls. During the 2nd yr the growth response was still significantly increased in boys (7.2 .+-. 1.9 cm). Bone age was more advanced and the period of previous i.m. treatment was longer in girls (6.7 vs. 3.6 yr) which may be the main cause of the waning 2nd yr response (4.7 .+-. 1.3 cm/yr). Pubertal development occurred in 9 children during treatment. The highest growth rates were not found in these children. Absence of antibodies against hGH and local reactions at the injection site is evidence of the safety of the treatment, which was very well accepted by the children. Daily s.c. injections thus represent an effective alternative to conventional i.m. injection ensuring high acceptance in children with growth hormone deficiency.