ABSTRACT
OBJETIVO: Valorar la efectividad del tratamiento con hormona de crecimiento (GH) en niños pequeños para la edad gestacional (PEG) sin crecimiento recuperador (talla al iniciar la terapia<−2,5 DE), en la Comunidad Valenciana, entre el 01/01/2003 y el 31/12/2013, y comparar los resultados con los ya publicados. MATERIAL Y MÉTODOS: Los datos antropométricos de los PEG que constituyeron la muestra de estudio se recogieron retrospectivamente de los documentos de solicitud de tratamiento existentes en la Consejería de Sanidad de Valencia. RESULTADOS: Un total de 115 sujetos comenzaron a tratarse entre el 01/01/2003 y el 31/12/2013, con dosis de GH de 0,035 ± 0,004 mg/kg/día, a una edad de 8,10 ± 2,75 años y con una talla de -3,14 ± 0,59 DE. Talla alcanzada tras 2 años de terapia (n = 115, edad: 10,50 ± 2,72 años): -2,11 ± 0,66 DE; y tras 4 años (n = 96, edad: 12,6 5± 2,46 años): -1,76 ± 0,75 DE. Esta última mejoría de talla coincide con edades a las que suele producirse el estirón puberal. Solo 35 de los 115 niños finalizaron el crecimiento, en el periodo de estudio, a una edad de 16,22 ± 1,19 años. Este subgrupo no consiguió normalizar la talla adulta (-2,22 ± 0,86 DE), ni alcanzar su talla diana (-1,72 ± 0,75 DE); no obstante, hubo una buena aproximación a la talla del progenitor más bajo (-1,95 ± 1,28 DE). El 42,9% de estos 35 casos experimentaron un incremento de estatura superior a 1 DE. CONCLUSIONES: La muestra estudiada no obtiene una respuesta de crecimiento tan satisfactoria como las de otras series publicadas. Probablemente, estos resultados mejorarían iniciando el tratamiento más precozmente, e individualizando las dosis según las características del paciente
OBJECTIVE: To analyse the effectiveness of growth hormone (GH) therapy in short-stature children born small for gestational age (SGA) without catch-up growth (height at the beginning of treatment<-2.5 SDS), in Valencia (Spain), between 01/01/2003 and 12/31/2013; and to compare our findings with previously published data. MATERIALS AND METHODS: Anthropometric data from the SGA children were obtained from the database of the "Ministry of Health of Valencia". These data were retrospectively reviewed. RESULTS: A total of 115 SGA children, with a mean age of 8.10±2.75 years and height of 3.14±0.59 SDS started treatment (dose: 0.035±0.004mg/kg/day) between January 1st, 2003 and March 31st, 2013. After 2 years of therapy (n = 115, age: 10.50 ± 2.72 years) the height SDS was 2.11 ± 0.66; and after 4 years (n = 96, age: 12.65 ± 2.46 years) of 1.76 ± 0.75 SDS. This latest improvement in stature matches ages at which the growth spurt usually occurs. Only 35 out of 115 children reached adult height, although impaired (− 2.22 ± 0.86 SDS), and failed to achieve their target height (− 1.72 ± 0.75 SDS). However, this sub-group grew to near the height of the shorter parent (−1.95 ±1.28 SDS), and 42,9% of these 35 cases increased their stature by more than 1 SDS. CONCLUSIONS: The studied sample did not achieve satisfactory growth results, as in other published series. Our findings might be improved by starting treatment earlier, and with doses individualised according to patient characteristics
Subject(s)
Humans , Male , Female , Human Growth Hormone/administration & dosage , Human Growth Hormone/pharmacology , Human Growth Hormone/therapeutic use , Gestational Age , Anthropometry/methods , Growth and Development , Growth and Development/physiology , Retrospective Studies , Evaluation of the Efficacy-Effectiveness of Interventions , Prenatal Diagnosis/trendsABSTRACT
OBJECTIVE: To analyse the effectiveness of growth hormone (GH) therapy in short-stature children born small for gestational age (SGA) without catch-up growth (height at the beginning of treatment<-2.5 SDS), in Valencia (Spain), between 01/01/2003 and 12/31/2013; and to compare our findings with previously published data. MATERIALS AND METHODS: Anthropometric data from the SGA children were obtained from the database of the «Ministry of Health of Valencia¼. These data were retrospectively reviewed. RESULTS: A total of 115 SGA children, with a mean age of 8.10±2.75 years and height of -3.14±0.59 SDS started treatment (dose: 0.035±0.004mg/kg/day) between January 1st, 2003 and March 31st, 2013. After 2 years of therapy (n=115, age: 10.50±2.72 years) the height SDS was -2.11±0.66; and after 4 years (n = 96, age: 12.65±2.46 years) of -1.76±0.75 SDS. This latest improvement in stature matches ages at which the growth spurt usually occurs. Only 35 out of 115 children reached adult height, although impaired (-2.22±0.86 SDS), and failed to achieve their target height (-1.72 ±0.75 SDS). However, this sub-group grew to near the height of the shorter parent (-1.95 ±1.28 SDS), and 42,9% of these 35 cases increased their stature by more than 1 SDS. CONCLUSIONS: The studied sample did not achieve satisfactory growth results, as in other published series. Our findings might be improved by starting treatment earlier, and with doses individualised according to patient characteristics.
