The effect of administering gonadotropin-releasing hormone agonist with recombinant-human growth hormone (GH) on the final height of girls with isolated GH deficiency: Results from a controlled study

To assess whether delaying puberty may improve final height in GH-deficient children with a poor height prediction at early puberty, we studied 24 girls with isolated GH deficiency until they reached their final height, in a controlled trial. Patients were taking recombinant human GH (r-hGH) substitutive therapy from 2.1 ± 0.5 yr (0.1 IU/kg·day sc) before entering the study, without showing any improvement in height prediction (149.6 ± 2.9 vs.150.3 ± 2.2 cm) on entering puberty. Fourteen girls agreed to add a GnRH agonist (GnRHa) to r-hGH, whereas the remaining 10 decided against it and served as controls. At the start of the study, girls treated with or without GnRHa had similar auxological characteristics (bone age, 10.9 ± 0.6 vs. 10.7 ± 1.3 yr; height sd score for chronological age, −1.87 ± 0.3 vs. −1.82 ± 0.2), including pubertal development. The GnRHa (long-acting d-Trp-6-GnRH) was given at 60μ g/kg im every 28 days for 1.9 ± 0.9 yr, then patients continued the r-hGH at the same dosage (3.1 ± 0.7 yr)...