At what age should growth hormone therapy be initiated in a 13-year-old boy with short stature (growth hormone deficiency)?

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From the FDA Drug Label

OMNITROPE is indicated for the treatment of children with growth failure due to inadequate secretion of endogenous growth hormone (GH). Pediatric Growth Hormone Deficiency (GHD) Generally, a dosage of 0.16 to 0.24 mg/kg body weight /week is recommended. Therapy with OMNITROPE should be supervised by a physician who is experienced in the diagnosis and management of pediatric patients with short stature associated with GHD

The age to initiate growth hormone therapy in a 13-year-old boy with short stature (growth hormone deficiency) is not explicitly stated in the label. However, since the patient is still a pediatric patient, growth hormone therapy can be initiated at any age if the patient has growth failure due to inadequate secretion of endogenous growth hormone (GH). The dosage should be individualized based on the growth response of each patient, with a generally recommended dosage of 0.16 to 0.24 mg/kg body weight/week. 1

From the Research

Growth Hormone Therapy Initiation

The ideal age for initiating growth hormone therapy in a 13-year-old boy with short stature due to growth hormone deficiency is not explicitly stated in the provided studies. However, the studies suggest that growth hormone therapy can be beneficial for children and adolescents with growth hormone deficiency, and the decision to initiate therapy should be made on a case-by-case basis.

Factors to Consider

Several factors should be considered when deciding whether to initiate growth hormone therapy, including:

  • The severity of the growth hormone deficiency
  • The child's height and growth velocity
  • The presence of other medical conditions that may affect growth
  • The potential benefits and risks of therapy

Guidelines for Growth Hormone Therapy

The studies provide guidelines for the use of growth hormone therapy in pediatric patients, including:

  • The US Food and Drug Administration (FDA) has approved growth hormone therapy for several indications, including growth hormone deficiency, Turner syndrome, and idiopathic short stature 2
  • The Paediatric and Adolescent Endocrine and Diabetes Society of South Africa recommends that growth hormone therapy be considered for children and adolescents with significantly short stature and poor growth velocity 3
  • The decision to use growth hormone therapy should be made in consultation with a pediatric endocrinologist 3

Age of Initiation

While the studies do not provide a specific age for initiating growth hormone therapy, they suggest that therapy can be beneficial for children and adolescents with growth hormone deficiency. One study found that growth hormone therapy was effective in increasing height velocity and improving psychosocial functioning in prepubertal boys with idiopathic short stature, with an average age of 10 years 4. Another study found that growth hormone therapy was effective in increasing adult height in children with growth hormone deficiency, with treatment initiated at an average age of 10-12 years 5.

Recommendations

Based on the available evidence, it is recommended that growth hormone therapy be initiated in children and adolescents with growth hormone deficiency, under the guidance of a pediatric endocrinologist, and taking into account the individual child's needs and circumstances 2, 3, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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