Comparison of body surface area versus weight-based growth hormone dosing for girls with turner syndrome

Lenneke Schrier, Marieke L. De Kam, Rachel McKinnon, Amalina Che Bakri, Wilma Oostdijk, Theo C.J. Sas, Leonie A. Menke, Barto J. Otten, Sabine M.P.F. De Muinck Keizer-Schrama, Berit Kristrom, Carina Ankarberg-Lindgren, Jacobus Burggraaf, Kerstin Albertsson-Wikland, Jan M. Wit

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)

Abstract

Background/Aims: Growth Hormone (GH) dosage in childhood is adjusted for body size, but there is no consensus whether body weight (BW) or body surface area (BSA) should be used. We aimed at comparing the biological effect and cost-effectiveness of GH treatment dosed per m2 BSA in comparison with dosing per kg BW in girls with Turner syndrome (TS). Methods: Serum IGF-I, GH dose, and adult height gain (AHG) from girls participating in two Dutch and five Swedish studies on the efficacy of GH were analyzed, and the cumulative GH dose and costs were calculated for both dose adjustment methods. Additional medication included estrogens (if no spontaneous puberty occurred) and oxandrolone in some studies. Results: At each GH dose, the serum IGF-I standard deviation score remained stable over time after an initial increase after the start of treatment. On a high dose (at 1 m2 equivalent to 0.056-0.067 mg/kg/day), AHG was at least equal on GH dosed per m2 BSA compared with dosing per kg BW. The cumulative dose and cost were significantly lower if the GH dose was adjusted for m2 BSA. Conclusion: Dosing GH per m 2 BSA is at least as efficacious as dosing per kg BW, and is more cost-effective.

Original languageEnglish
Pages (from-to)319-330
Number of pages12
JournalHormone Research in Paediatrics
Volume81
Issue number5
DOIs
Publication statusPublished - Jun 2014

Keywords

  • Adult height
  • Body surface area
  • Body weight
  • Cost-effectiveness
  • Growth hormone therapy
  • Turner syndrome

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