Cassorla Fernando, Cianfarani Stefano, Haverkamp Fritz, Labarta Jose I, Loche Sandro, Luo Xiaoping, Maghnie Mohamad, Mericq Veronica, Muzsnai Agota, Norgren Svante, Ojaniemi Marja, Pribilincova Zuzana, Quinteiro Sofia, Savendahl Lars, Spinola e Castro Angela, Gasteyger Christoph
Institute of Maternal and Child Research, University of Chile, Santa Rosa 1234, Santiago, Chile.
Pediatr Endocrinol Rev. 2011 Dec;9(2):554-65.
Although there are guidelines for treatment of short stature, open questions regarding optimal management of growth hormone therapy still exist. Experts attending six international meetings agree that successful therapy results in the patient attaining mid-parental height, and relies on correct diagnosis and early intervention. Experts advocate patient followup every 3-6 months, and that growth and adherence should be monitored at each visit. Growth response is variable, and an accepted definition of good/poor response is lacking. Combined with patient education and regular patient follow-up, a definition of treatment response could lead to improved treatment outcomes. Few experts use prediction models in clinical practice, but all agree that pharmacogenetics might improve prediction, enable early therapy modulation, and promote growth. Poor growth is often due to low adherence. Guidance on optimal management of growth hormone therapy is required, with focus on early diagnosis, dosing, treatment monitoring, adherence, and motivation.
