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      Treatment of Children Born Short for Gestational Age: A European Perspective

      Hormone Research in Paediatrics

      S. Karger AG

      Adult height, Growth hormone, Short stature

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          Abstract

          The use of growth hormone (GH) has progressively moved from a substitution therapy to a pharmacological agent promoting growth when it is otherwise considered insufficient. This process has progressed stepwise from conditions with definite diagnoses such as Turner syndrome towards children born small for gestational age (SGA) and more recently those with idiopathic short stature. Unsurprisingly, no set European or national perspective can be presented given the multiple points of view that must be taken into account when considering these treatments. In France, the use of GH has been approved for use in SGA children since 1995 and has been covered by the national insurance system since 1997. National data regarding the use of GH for this indication will be presented, in particular with regard to the recommendations for use made by the national insurance system. In 2003, after a complex procedure lasting more than 2 years, two GH preparations, including Norditropin<sup>®</sup>, were approved at European level for use in SGA children. Based on the data presented, the European Medicines Evaluation Agency approved a dose of 35 µg/kg per day, which is that generally used in GH deficiency. This is paradoxical, given that GH-deficient children are generally considered to be more sensitive to treatment than their non-GH-deficient counterparts. It is of interest that the influence of GH dose on outcome has only been demonstrated in the first years of treatment and not in any long-term, near-adult-height analyses. Thus the ‘European perspective’ emphasizes long-term results rather than short-term catch-up. By contrast, in the USA a higher dose is recommended, emphasizing on short-term gain. Other differences concern the minimum age at the start of treatment and the minimum height deficit before chronic treatment can be instituted.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          978-3-8055-8009-0
          978-3-318-01274-3
          1663-2818
          1663-2826
          2005
          November 2005
          15 November 2005
          : 64
          : Suppl 2
          : 62
          Affiliations
          Endocrinologie Pédiatrique and INSERM U561, Groupe Hospitalier Cochin–Saint Vincent de Paul, Paris, France
          Article
          87755 Horm Res 2005;64:62–62
          10.1159/000087755
          © 2005 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 1
          Categories
          Treatment of SGA Children

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