Expensive therapies in children: Benefit versus cost of combined treatment of recombinant human growth hormone and gonadotropin-releasing hormone analogue in girls with poor height potential

Meropi Toumba, Vasilis Kokotsis, Savvas C. Savva, Nicos Skordis

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The combination therapy of gonadotropin-releasing hormone analogues (GnRHa) and recombinant human growth hormone (rhGH) has been used to increase growth in children with premature sexual maturation and attenuated growth. The aim of this report was to study the benefit over cost of combined treatment in girls with central precocious puberty (CPP) and poor height prognosis and in girls with idiopathic short stature (ISS) and early puberty. Should this expensive treatment be given to such patients? Subjects and methods: Two patient groups were included: five girls with central precocious puberty (CPP) who reached final height (FH) at 16.3±1.2 years and eight girls with ISS who reached FH at 14.7±0.8 years. Patients were treated for 3.5±0.6 years. Results: In both groups, FH improved significantly; in CPP from -1.3 to -0.5 standard deviation score (SDS) (p=0.030) and in ISS from -2.6 to -1.7 SDS (p=0.012). Only girls with CPP reached their target height (-0.5 vs. -0.6 SDS) (p=0.500). Conclusions: Both groups had a total height gain of 5 cm. Each centimetre cost about €2700 per patient. This treatment should be considered only in patients with extremely low height prediction and very early pubertal onset.

Original languageEnglish
Pages (from-to)311-316
Number of pages6
JournalJournal of Pediatric Endocrinology and Metabolism
Volume27
Issue number3-4
DOIs
Publication statusPublished - 1 Mar 2014

Keywords

  • central precocious puberty
  • combined treatment of GH and GnRHa
  • final height
  • idiopathic short stature

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