Benchmarking of growth hormone therapy in Hong Kong: ten-year data from the multi-centre GROWTH study.
The median one-year change in height standard deviation score with rhGH therapy was 0.41, indicating some growth but with significant variability among patients.
Where it sits
this study against the rest of the hgh (somatropin) corpusSummary and findings
This study evaluated the efficacy of recombinant human growth hormone (rhGH) therapy in children and adolescents in Hong Kong over a ten-year period. The cohort included 161 males and 190 females, primarily with growth hormone deficiency (GHD). The median one-year change in height standard deviation score (HtSDS) was 0.41.
Abstract
<h4>Objective</h4>To evaluate the local practice and short-term efficacy of recombinant human growth hormone (rhGH) therapy in children and adolescents in Hong Kong.<h4>Methods</h4>A retrospective analysis of rhGH therapy in children and adolescents between 2013 and 2022 who attended six Hong Kong centres that had enrolled in GloBE-Reg.<h4>Results</h4>The cohort comprised 161 males and 190 females with a range of clinical indications that consisted mainly of growth hormone deficiency (GHD) (n = 147, 41%). The median age at rhGH initiation was 10.1 years (range, 0.3, 18.1). Median one-year change in height standard deviation score (HtSDS) was available in 319 children (90.8%) and was 0.41 (range, -0.98, 3.4). The median starting dose of rhGH for GHD was 0.028 mg/kg/day (range, 0.008, 0.051).<h4>Conclusions</h4>This multicentre study shows the utility of GloBE-Reg for understanding the use of rhGH therapy at a regional level. Findings demonstrate a variation in clinical practice as well as in short-term growth outcomes. These results support the need for continued optimisation of rhGH therapy through local benchmarking and care quality improvement activities.
Background
This study addresses the use of recombinant human growth hormone (rhGH) therapy in children and adolescents, focusing on local practices and short-term efficacy. Previous research has indicated variability in growth outcomes associated with rhGH therapy, but specific data from Hong Kong were limited. Understanding local practices is crucial for optimizing treatment and improving care quality.
Methods
This was a retrospective analysis of rhGH therapy conducted from 2013 to 2022 across six centers in Hong Kong. The population included 351 children and adolescents, primarily diagnosed with growth hormone deficiency (GHD). The primary outcome measure was the change in height standard deviation score (HtSDS) after one year of treatment.
Results
The median one-year change in height standard deviation score (HtSDS) was 0.41 (range, -0.98, 3.4), with data available for 319 children (90.8%). The median starting dose of rhGH for those with GHD was 0.028 mg/kg/day (range, 0.008, 0.051).
Interpretation
The findings indicate a modest increase in height standard deviation score after one year of rhGH therapy, but the clinical significance of a median change of 0.41 may be limited. The study's retrospective nature and the specific population may introduce confounding factors that affect the generalizability of the results. These findings highlight the need for ongoing evaluation and optimization of rhGH therapy in clinical practice.
Key findings
- n=351 children and adolescents evaluated for rhGH therapy.
- Median age at rhGH initiation was 10.1 years (range, 0.3, 18.1).
- Median one-year change in height standard deviation score (HtSDS) was 0.41 (range, -0.98, 3.4).
- Median starting dose of rhGH for GHD was 0.028 mg/kg/day (range, 0.008, 0.051).
- 41% of the cohort had growth hormone deficiency (n=147).
Limitations
- Retrospective analysis may introduce confounding variables.
- Findings may not be generalizable beyond the specific centers involved.
- Short follow-up duration limits long-term efficacy assessment.