Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents With Transient Idiopathic GHD
Year: 2025
Type: article
Abstract: CONTEXT: In children with idiopathic isolated growth hormone deficiency (IIGHD), GH secretion often normalizes by near adult height (NAH). Whether recombinant human GH (rhGH) treatment can be safely discontinued earlier remains unclear. OBJECTIVE: This work aimed to investigate if withdrawing rhGH treatment from mid-puberty onward had no negative effect on attained NAH in adolescents who, after retesting, were no longer GH deficient. METHODS: A prospective multicenter patient preference study was conducted at pediatric endocrinology departments in multiple centers (2017-2024) with follow-up until NAH (SEENEZ GH Study). Participants included 127 adolescents (95 male, 75%) with childhood IIGHD (GH peak 1.7-10 µg/L) who tested GH sufficient (GH peak >6.7 µg/L) at mid-puberty. Forty-four continued rhGH (GHcont), 83 discontinued (GHstop). A total of 99% of patients completed the study. Intervention included rhGH treatment continuation vs discontinuation from mid-puberty until NAH. The primary outcome measure was NAH-SDS minus target height (TH)-SDS. The secondary outcome was NAH-SDS, total pubertal growth (TPG), and predicted vs attained height gain. RESULTS: Mean (SD) NAH-SDS minus TH-SDS was -0.17 (0.60) in the GHcont and -0.18 (0.62) in the GHstop group (P = .96). Mean NAH-SDS was -0.91 (0.76) (GHcont) vs -0.78 (0.76) (GHstop) (P = .35). Mean (SD) TPG (from start of puberty) in males was 27.5 cm (7.0; GHcont) vs 25.9 cm (6.2; GHstop) (P = .25) and in females 20.5 cm (5.7; GHcont) vs 20.9 cm (7.6; GHstop) (P = .90). Predicted vs attained height gain based on the prediction model did not differ between groups. CONCLUSIONS: In adolescents with transient IIGHD, rhGH treatment can be stopped at mid-puberty. These findings support reducing rhGH treatment duration, lowering patient burden and health-care costs.
Authors: Joeri Vliegenthart, Jan M Wit, Boudewijn Bakker, Annemieke M Boot, Christiaan de Bruin, Martijn J J Finken, Josine C van der Heyden, Anita C S Hokken-Koelega, Hetty J van der Kamp, Edgar G van Mil, Theo C J Sas, Dina A Schott, Petra van Setten, Saartje Straetemans, Vera van Tellingen, Robbert N H Touwslager, A S Paul van Trotsenburg, Paul G Voorhoeve, Edmond H H M Rings, Erica L T van den Akker, Danielle C M van der Kaay
Institutions: Erasmus MC - Sophia Children’s Hospital, Leiden University, Leiden University Medical Center, Willem-Alexander Kinderziekenhuis, Reinier de Graaf Hospital, University Medical Center Groningen, Beatrix Kinderziekenhuis, Amsterdam UMC Location University of Amsterdam, Emma Kinderziekenhuis, Amsterdam University Medical Centers, Sint Franciscus Gasthuis, Erasmus MC, Utrecht University, University Medical Center Utrecht, Wilhelmina Children's Hospital, Jeroen Bosch Ziekenhuis, Zuyderland Medisch Centrum, Radboud University Nijmegen, Radboud University Medical Center, Amalia Kinderziekenhuis, Maastricht University Medical Centre, Catharina Ziekenhuis, St. Antonius Ziekenhuis, Canisius-Wilhelmina Ziekenhuis
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,750
Funder: ZonMw
Award: G1459862523
OpenAlex ID: W4416256925