What is the role of medications in the treatment of hyposomatotropism (growth hormone deficiency [GHD])?

Updated: Jan 24, 2019
  • Author: Sunil Kumar Sinha, MD; Chief Editor: Robert P Hoffman, MD  more...
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Answer

Growth hormone (GH) extracted from cadaveric pituitary glands was used to treat hypopituitarism in children for more than 30 years until 1985, when recombinant human GH (rhGH) became commercially available. Cadaveric hGH was effective. However, complications associated with its use were an inadequate supply, variable biopotencies, and the transmission of Creutzfeldt-Jakob disease.

rhGH and novel treatment modalities

Widespread production of rhGH has increased worldwide use of rhGH. Dosing of rhGH remains arbitrary to some degree.

  • In the United States, the customary starting dosage is 0.3 mg/kg/wk given subcutaneously divided in 7 nightly injections.

  • In Japan and in many European countries, the customary dosage is approximately 0.025 mg/kg/d or 0.15 mg/kg/wk (50% of the US dose).

With respect to nomenclature and conversion, 3 IU of rhGH = 1 mg of rhGH.

In children who have completely GH deficient, rhGH typically accelerates linear growth to 10-12 cm/yr during the first year of therapy and to 7-9 cm/yr in the second and third years.


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