Growth Velocity and Economic Aspects of Human Growth Hormone Treatment in an Egyptian Cohort with Multiple Pituitary Hormone Deficiency: A Retrospective Minireview

Amany Ibrahim Mohamed Mohamed Attia; Abeer Atef; Nora Badawi; Marise Abdou; Sahar Yassin; Eatemad Helmy; Hoda Atef Abdelsattar Ibrahim

doi:10.3889/oamjms.2022.9060

Authors

Amany Ibrahim Mohamed Mohamed Attia Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
Abeer Atef Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
Nora Badawi Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit, Faculty of Medicine, Cairo University, Cairo, Egypt https://orcid.org/0000-0002-2037-6844
Marise Abdou Department of Pediatrics, Diabetes Endocrine and Metabolism Pediatric Unit, Faculty of Medicine, Cairo University, Cairo, Egypt https://orcid.org/0000-0001-9961-5299
Sahar Yassin Department of Community Medicine and Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
Eatemad Helmy Department of Pediatrics and Neonatology, Mataria Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
Hoda Atef Abdelsattar Ibrahim Department of Pediatric Clinical Nutrition, Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt https://orcid.org/0000-0001-5399-8861

DOI:

https://doi.org/10.3889/oamjms.2022.9060

Keywords:

Multiple pituitary hormone deficiency, Growth velocity, Human growth hormone treatment

Abstract

Abstract

Background: Multiple pituitary hormone deficiency (MPHD) is a chronic lifelong disease. Human recombinant growth hormone (hGH) treatment is the optimal therapy for short stature in children with growth hormone (GH) deficiency in patients with MPHD and can effectively increase growth velocity (GV) to attain adult heights within the target range. Objective: to assess the GV during hGH treatment of children with MPHD, to analyze the characteristics of patients and to investigate the possible factors that might affect their height gain. Methods: Data from 18 (8 females) children and adolescents with MPHD with GH, thyroid stimulating hormone, gonadotropin and adrenocorticotropic hormone deficiencies were collected. Subjects were divided into groups: 12 pubescent patients and 6 pre-pubescent patients. Anthropometric measurements were reported regularly for one year. Results: age at onset of study was 13.44±4.66 years. CT and MRI findings were positive in 77.8 %. Peak GH levels after Clonidine and Insulin were 4.06±2.61 and 5.39±4.2 ng/ml respectively. GH was received in a dose of 0.95±0.5 mg/day. Height gain during the period of the study was 3.5±0.47cm /year. The predicted adult height at the first and last visits and delta predicted adult height between the first and last visits were 155.78±10.159, 156.71±7.22 and 0.93±4.64 cm respectively. The cost in dollars was identified using Markov cost-effectiveness simulation model as 98.87±52.4 dollars per one cm height gain, with a total of 346.07±183.42 US dollars/patient/year. For a hGH dose of 0.02±0.01 mg/kg/d (0.95±0.5mg/day). There was a positive correlation between height gain during the study period and both the height SDS at presentation and dose of GH mg/kg/d. Conclusion: the height gain and the cost were higher amongst females than males with MPHD. Height at presentation and hGH dose seemed to be an effective predictor for height gain in patients with MPHD.

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