From the Guidelines
Sermorelin should be used under medical supervision to treat growth hormone deficiency, with a typical dosage of 100-500 mcg administered via subcutaneous injection once daily, prioritizing the reduction of morbidity, mortality, and improvement of quality of life.
Key Considerations
- The use of sermorelin is primarily for treating growth hormone deficiency in children and adults, and its application in anti-aging is also noted 1.
- The mechanism of action involves mimicking growth hormone-releasing hormone (GHRH) to stimulate natural growth hormone production, potentially reducing side effects compared to direct growth hormone replacement 1.
- Benefits may include improved muscle mass, reduced body fat, enhanced energy, better sleep quality, and improved skin elasticity, with generally mild side effects such as injection site reactions, headache, or flushing 1.
- It is crucial to use sermorelin under medical supervision to avoid hormonal imbalances and to ensure proper dosage and treatment duration, which can vary based on individual needs and may continue for several months to achieve optimal results 1.
- The multifactorial nature of growth failure in chronic kidney disease (CKD) includes factors such as intrauterine growth restriction, genetic factors, prematurity, malnutrition, and disturbances in the somatotropic and gonadotropic hormone axes, which can be addressed with recombinant human growth hormone (GH) therapy to stimulate IGF1 synthesis and promote longitudinal growth 1.
Clinical Recommendations
- GH therapy should be considered for children with stage 3–5 CKD or on dialysis who have persistent growth failure, defined as a height below the third percentile for age and sex and a height velocity below the twenty-fifth percentile, once other potentially treatable risk factors for growth failure have been adequately addressed 1.
- The dosage of GH should be 0.045–0.05 mg/kg per day by daily subcutaneous injections until the patient has reached their final height or until renal transplantation 1.
- Regular monitoring is essential, including clinic visits every 3–6 months or more frequently for young patients and those with advanced CKD, to assess stature, height velocity, pubertal development, skeletal maturation, renal function, and other relevant parameters 1.
- Sermorelin and GH therapy require careful consideration of indications and contraindications, including the presence of closed epiphyses, hypersensitivity to the active substance or excipients, severe secondary hyperparathyroidism, and active malignancy, among others 1.
From the Research
Sermorelin Overview
- Sermorelin is a 29 amino acid analogue of human growth hormone-releasing hormone (GHRH) with full biological activity of GHRH 2
- It is used in the diagnosis and treatment of children with idiopathic growth hormone deficiency
Diagnosis of Growth Hormone Deficiency
- Sermorelin can be used as a provocative test for the diagnosis of growth hormone deficiency in children 2
- In adults, the diagnosis of growth hormone deficiency requires stimulation testing, such as insulin, glucagon, growth hormone releasing hormone-arginine or macimorelin 3
- Serum insulin-like growth factor I (IGF-I) levels can be used to support the diagnosis, but lack sufficient sensitivity and specificity in adults 3
Treatment of Growth Hormone Deficiency
- Sermorelin has been shown to be effective in promoting growth in some prepubertal children with idiopathic growth hormone deficiency 2
- Once daily subcutaneous sermorelin 30 microg/kg bodyweight has been shown to increase height velocity in children with growth hormone deficiency 2
- Growth hormone replacement therapy has been shown to have beneficial effects on quality of life and cardiovascular risk factors in adults with growth hormone deficiency 4