Final Height in Patients with Turner Syndrome after Treatment with GH

Abstract

Clinical trials of human GH therapy for Turner syndrome were started in 1986. The number of patients enrolled from 1986 to 1989 was 375. The age at the start of treatment ranged from 5 to 18 with a mean of 10 years. About half of the enrolled patients stopped receiving the therapy within 3 years. A total of 115 patients were treated for more than six years with recombinant hGH. Fifty-one patients received hGH at a weekly dosage of 0.5 IU/kg and 64 received 1.0 IU/kg by daily sc injection. Both treatment groups showed a statistically significant growth increase during the initial 4 years of treatment. The high dose increased height velocity to a significantly greater degree for the initial 2 years as compared with the low dose so that the increase in height over the 6 year treatment with 0.5 IU/kg/W and 1.0 IU/kg/W, as expressed by the SD score (δSDS) for chronological age, was 1.5 and 1.8, respectively. Ninety percent of the patients above the age of 14 exceeded their projected adult height. During the 6 years of treatment, 260 patients stopped or ceased GH therapy. In 31 percent of the patients, the height was above - 2SD for normal girls. In 27% of the patients, the growth rate was not sufficient when they stopped treatment. The final height (FH) of Turner patients was tentatively designated to be the height when the growth rate became <1 cm/year. FH was greater in patients who were treated with GH for more than 6 years. The mean FH of the patients above 17 years who were treated for more than 6 years was 145.5 ± 3.0 cm (N=6) with hGH 0.5 IU/kg/W, and 143.8 ± 2.8 cm (N=12) with hGH 1.0 IU/kg/W. Although FH did not differ statistically for the two treatments, adult height was improved 6-8 cm by GH treatment. No remarkable adverse event occurred during the treatment. These results indicate that hGH treatment improve the final height in patients with Turner syndrome.