DOES PRETREATKENT WITH GHRH CHANGE THE GROWIH RESPONSE TO GH THERAPY?

Abstract

Thirty-six prepubertal children with GHD, 21 boys and 15 girls aged 4.25 to 13.00 years, bone age (BA) from 2.0 to 9.5 years with growth deficiency from −1.36 to −5.62 SD to chronological age, were treated with daily subcutaneous injections of GHRH 1-29 or 1-44 at a dose of 10 μg/kg/day for 6 months. After a six month interval, treatment with biosynthetic growth hormone (Maxmoat, Sanofi) at a dose of 0.6 U/kg/week in subcutaneous injections 6-7 times per week was instituted. The growth velocity at various stages of observation and treatment was determined. The results were compared with a control group made up of 14 prepubertal GHD children who had not been treated with GHRH. 11 boys and 3 girls aged 3.75 to 13.83 years, BA 1.5 to rested for the first time with biosynthetic growth hormone (Maxomat, Sanofi] according to the same protocal and dose as above. The growth velocity (GV) during successive periods of observation was found to be: GV before any treatment was not statistically different between both group (t=0.87, p - ns). BA (t=1.545, p - ns) between both groups before any treatment did not differ statistically. Before GH treatment, BA in patients treated with GHRH was statiscally higher than in the control group (t=2.21. p (0.005), and remained mere advanced during GH treatment with the difference between both groups significant (t=2.03, p <0.05). Our data indicate that in spite of the fact that before any treatment, the studied groups did not differ in terms of BA and GV, before institution of GH therapy, a statiscally significant difference was found between BA and GV in both groups. It is difficult to conclude on the basis of our material if the GV in group I during GH treatment was dependent mainly on pretreatment with GHRH or were more advanced BA and/or higher GV before initiation of GH therpy also decisive factors. In the group treated with GHRH, no correlation was found between the GV in response to GH and the GV observed during GHRH treatment (r = −0.17, p - ns). The growth response to GHRH does not seem to be a prognostic of response to GH therapy.