Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area

INTRODUCTION: Both body weight (BW)- and body surface area (BSA)-based dosing regimens have been recommended for growth hormone (rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on anthropometric factors. METHODS: The retro...

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Main Authors: Özge Besci, Reyhan Deveci Sevim, Kübra Yüksek Acinikli, Gözde Akın Kağızmanlı, Sezen Ersoy, Korcan Demir, Tolga Ünüvar, Ece Böber, Ahmet Anık, Ayhan Abacı
Format: Article
Language:English
Published: Galenos Yayincilik 2023-09-01
Series:JCRPE
Subjects:
Online Access:https://jcrpe.org/jvi.aspx?pdir=jcrpe&plng=eng&un=JCRPE-94803&look4=
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author Özge Besci
Reyhan Deveci Sevim
Kübra Yüksek Acinikli
Gözde Akın Kağızmanlı
Sezen Ersoy
Korcan Demir
Tolga Ünüvar
Ece Böber
Ahmet Anık
Ayhan Abacı
author_facet Özge Besci
Reyhan Deveci Sevim
Kübra Yüksek Acinikli
Gözde Akın Kağızmanlı
Sezen Ersoy
Korcan Demir
Tolga Ünüvar
Ece Böber
Ahmet Anık
Ayhan Abacı
author_sort Özge Besci
collection DOAJ
description INTRODUCTION: Both body weight (BW)- and body surface area (BSA)-based dosing regimens have been recommended for growth hormone (rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on anthropometric factors. METHODS: The retrospective study included children diagnosed with idiopathic isolated growth hormone deficiency. BW-based dosing in mcg/kg/day was converted to BSA in mg/m2/day to determine the equivalent amounts of the given rhGH. Those with a BW-to-BSA ratio of more than 1 were allocated to the “relatively over-dosed group”, while the remaining patients with a ratio of less than 1 were assigned to the “relatively under-dosed” group. Patients with a height gain greater than 0.5 standard deviation score (SDS) at the end of one year were classified as the height gain at goal (HAG), whereas those with a height gain of less than 0.5 SDS were assigned as the height gain not at goal (NHAG). RESULTS: The study included 60 patients (18 girls, 30%). Thirty-six (60%) patients were classified as HAG. The ratio of dosing based on BW-to-BSA was positively correlated both with the ages and body mass index (BMI) levels of the patients, leveling off at the age of 11 at a BMI of 18 kg/m2. The relative dose estimations (over- and under-dosed groups) differed significantly between the patients classified as HAG or NHAG. Fifty-six percent of NHAG compared to 44% of HAG patients received relatively higher doses, while 79% of HAG compared to 21% of NHAG received relatively lower doses (p=0.006). When the patients were subdivided according to their pubertal status, higher doses were administrated mostly to the pubertal patients in both the NHAG and HAG groups. In the pre-pubertal age group, 73% of NHAG compared to 27% of HAG received relatively higher doses, while 25% of NHAG compared to 75% of HAG received relatively lower doses (p=0.01). DISCUSSION AND CONCLUSION: Dosing based on BW may be preferable in both prepubertal and pubertal children who do not show adequate growth responses. In prepubertal children, relatively lower doses calculated based on BW rather than BSA provide similar efficacy at lower costs.
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spelling doaj.art-ea5c25ee1f9740498a9298f7cec358052023-08-24T11:15:15ZengGalenos YayincilikJCRPE1308-57271308-57352023-09-0115326827510.4274/jcrpe.galenos.2023.2022-12-18JCRPE-94803Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface AreaÖzge Besci0https://orcid.org/0000-0003-3135-9617Reyhan Deveci Sevim1https://orcid.org/0000-0003-0068-146XKübra Yüksek Acinikli2https://orcid.org/0000-0001-9492-4834Gözde Akın Kağızmanlı3https://orcid.org/0000-0002-6158-9002Sezen Ersoy4https://orcid.org/0000-0002-4592-3146Korcan Demir5https://orcid.org/0000-0002-8334-2422Tolga Ünüvar6https://orcid.org/0000-0002-5517-5030Ece Böber7https://orcid.org/0000-0001-8828-0892Ahmet Anık8https://orcid.org/0000-0002-7729-7872Ayhan Abacı9https://orcid.org/0000-0002-1812-0321Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, TurkeyAydın Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Aydın, TurkeyDokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, TurkeyDokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, TurkeyDokuz Eylül University Faculty of Medicine, Department of Pediatrics, İzmir, TurkeyDokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, TurkeyAydın Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Aydın, TurkeyDokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, TurkeyAydın Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Aydın, TurkeyDokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, TurkeyINTRODUCTION: Both body weight (BW)- and body surface area (BSA)-based dosing regimens have been recommended for growth hormone (rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on anthropometric factors. METHODS: The retrospective study included children diagnosed with idiopathic isolated growth hormone deficiency. BW-based dosing in mcg/kg/day was converted to BSA in mg/m2/day to determine the equivalent amounts of the given rhGH. Those with a BW-to-BSA ratio of more than 1 were allocated to the “relatively over-dosed group”, while the remaining patients with a ratio of less than 1 were assigned to the “relatively under-dosed” group. Patients with a height gain greater than 0.5 standard deviation score (SDS) at the end of one year were classified as the height gain at goal (HAG), whereas those with a height gain of less than 0.5 SDS were assigned as the height gain not at goal (NHAG). RESULTS: The study included 60 patients (18 girls, 30%). Thirty-six (60%) patients were classified as HAG. The ratio of dosing based on BW-to-BSA was positively correlated both with the ages and body mass index (BMI) levels of the patients, leveling off at the age of 11 at a BMI of 18 kg/m2. The relative dose estimations (over- and under-dosed groups) differed significantly between the patients classified as HAG or NHAG. Fifty-six percent of NHAG compared to 44% of HAG patients received relatively higher doses, while 79% of HAG compared to 21% of NHAG received relatively lower doses (p=0.006). When the patients were subdivided according to their pubertal status, higher doses were administrated mostly to the pubertal patients in both the NHAG and HAG groups. In the pre-pubertal age group, 73% of NHAG compared to 27% of HAG received relatively higher doses, while 25% of NHAG compared to 75% of HAG received relatively lower doses (p=0.01). DISCUSSION AND CONCLUSION: Dosing based on BW may be preferable in both prepubertal and pubertal children who do not show adequate growth responses. In prepubertal children, relatively lower doses calculated based on BW rather than BSA provide similar efficacy at lower costs.https://jcrpe.org/jvi.aspx?pdir=jcrpe&plng=eng&un=JCRPE-94803&look4=body surface areabody weightgrowth hormoneigf-1igfbp-3pharmacotherapy
spellingShingle Özge Besci
Reyhan Deveci Sevim
Kübra Yüksek Acinikli
Gözde Akın Kağızmanlı
Sezen Ersoy
Korcan Demir
Tolga Ünüvar
Ece Böber
Ahmet Anık
Ayhan Abacı
Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area
JCRPE
body surface area
body weight
growth hormone
igf-1
igfbp-3
pharmacotherapy
title Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area
title_full Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area
title_fullStr Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area
title_full_unstemmed Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area
title_short Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area
title_sort growth hormone dosing estimations based on body weight versus body surface area
topic body surface area
body weight
growth hormone
igf-1
igfbp-3
pharmacotherapy
url https://jcrpe.org/jvi.aspx?pdir=jcrpe&plng=eng&un=JCRPE-94803&look4=
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