Genotropin (somatropin, rbe) & Patient Transition

Treatment in young adults and adolescents

Continued growth hormone (GH) treatment can have benefits beyond final height 1-11

Not all adolescent patients will need to continue GH therapy after reaching final height. However, some adult patients with growth hormone deficiency (GHD) may see benefits by continuing GH therapy beyond final height: 12

  • Proven maturation of body composition

Continuing GH therapy after final height increases lean body mass and decreases fat mass 2-4

  • Increase in bone mass and density

Continuing GH therapy induces a significant progression towards peak bone mass 5,6

Continuation of Genotropin (somatropin) therapy beyond final height helps ensure that childhood-onset GHD patients achieve full somatic development 1-11

Current Guidelines for Patient Transition to Adult Treatment

Children with GH deficiency should be treated as outlined in the NICE Technology Appraisal Guidance 188.

When linear growth has been achieved with a growth rate < 2 cm/year, GH treatment should be stopped for 2–3 months, and then GH status should be re-assessed.

As outlined in the NICE Technology Appraisal Guidance TA64 GH treatment at adult doses should be re-started only in those satisfying the biochemical criteria for severe GH deficiency (defined as a peak GH response of less than 9 mU/litre (3 ng/ml) during an insulin tolerance test or a cross-validated GH threshold in an equivalent test), and continued until adult peak bone mass has been achieved (normally around 25 years of age).

After adult peak bone mass has been achieved, the decision to continue growth hormone treatment should be based on all the specified criteria for adult growth hormone replacement therapy .

Support Materials for Patients

Pfizer has developed booklets to support young adults transitioning to adult care.

Please visit our Helpline and Support page for further information.

References

1. Clayton P, et al. Growth Horm IGF Res 2007; 17: 369–382.

2. Vahl N, et al. J Clin Endocrinol Metab 2000; 85: 1874–1881.

3. Attanasio A, et al. J Clin Endocrinol Metab 2004; 89: 4857–4862.

4. Carroll P, et al. J Clin Endocrinol

5. Drake W, et al. J Clin Endocrinol Metab 2003; 88: 1658–1663.

6. Shalet S, et al. J Clin Endocrinol Metab 2003; 88: 4124–4129.

7. Underwood L, et al. J Clin Endocrinol Metab 2003; 88: 5273–5280.

8. Johannsson G, et al. J Clin Endocrinol Metab 1999; 84: 4516–4524.

9. Nørrelund H, et al. J Clin Endocrinol Metab 2000; 85: 1912–1917.

10. Fors H, et al. Clin Endocrinol 2001; 55: 617–624.

11. Mauras N, et al. J Clin Endocrinol Metab 2005; 90: 3946–3955.

12. Thomas J & Monson J. Eur J Endocrinol 2009; 161: S97–S106.

13. NICE Guideline [TA188]. Human growth hormone (somatropin) for the treatment of growth failure in children.

 

PP-GEN-GBR-0466. July 2018