BACKGROUND: The growth hormone-IGF (insulin-like growth factor) system plays a central role in hormonal growth regulation. Recombinant human (rh) growth hormone (GH) has been available since the late 1980s for replacement therapy in GH-deficient patients and for the stimulation of growth in patients with short stature of various causes. Growth promotion by GH occurs in part indirectly through the induction of IGF-1 synthesis. In primary disturbances of IGF-1 production, short stature can only be treated with recombinant human IGF-1 (rhIGF-1). rhIGF-1 was recently approved for this indication but can also be used to treat other conditions. METHODS: Selective review of the literature on IGF-1 therapy, based on a PubMed search. RESULTS AND CONCLUSION: In children with severe primary IGF-1 deficiency (a rare condition whose prevalence is less than 1:10,000), the prognosis for final height is very poor (ca. 130 cm), and IGF-1 therapy is the appropriate form of pathophysiologically based treatment. There is no alternative treatment at present. The subcutaneous administration of IGF-1 twice daily in doses of 80 to 120 microg/kg accelerates growth and increases final height by 12 to 15 cm, according to current data. There is, however, a risk of hypoglycemia, as IGF-1 has an insulin-like effect. As treatment with IGF-1 is complex, this new medication should only be prescribed, for the time being, by experienced pediatric endocrinologists and diabetologists.
BACKGROUND: The growth hormone-IGF (insulin-like growth factor) system plays a central role in hormonal growth regulation. Recombinant human (rh) growth hormone (GH) has been available since the late 1980s for replacement therapy in GH-deficientpatients and for the stimulation of growth in patients with short stature of various causes. Growth promotion by GH occurs in part indirectly through the induction of IGF-1 synthesis. In primary disturbances of IGF-1 production, short stature can only be treated with recombinant humanIGF-1 (rhIGF-1). rhIGF-1 was recently approved for this indication but can also be used to treat other conditions. METHODS: Selective review of the literature on IGF-1 therapy, based on a PubMed search. RESULTS AND CONCLUSION: In children with severe primary IGF-1 deficiency (a rare condition whose prevalence is less than 1:10,000), the prognosis for final height is very poor (ca. 130 cm), and IGF-1 therapy is the appropriate form of pathophysiologically based treatment. There is no alternative treatment at present. The subcutaneous administration of IGF-1 twice daily in doses of 80 to 120 microg/kg accelerates growth and increases final height by 12 to 15 cm, according to current data. There is, however, a risk of hypoglycemia, as IGF-1 has an insulin-like effect. As treatment with IGF-1 is complex, this new medication should only be prescribed, for the time being, by experienced pediatric endocrinologists and diabetologists.
Authors: J Guevara-Aguirre; A L Rosenbloom; O Vasconez; V Martinez; S E Gargosky; L Allen; R G Rosenfeld Journal: J Clin Endocrinol Metab Date: 1997-02 Impact factor: 5.958
Authors: J Guevara-Aguirre; O Vasconez; V Martinez; A L Martinez; A L Rosenbloom; F B Diamond; S E Gargosky; L Nonoshita; R G Rosenfeld Journal: J Clin Endocrinol Metab Date: 1995-04 Impact factor: 5.958
Authors: A D Goddard; R Covello; S M Luoh; T Clackson; K M Attie; N Gesundheit; A C Rundle; J A Wells; L M Carlsson Journal: N Engl J Med Date: 1995-10-26 Impact factor: 91.245
Authors: Sarah C Grünert; Stephanie Müllerleile; Linda De Silva; Michael Barth; Melanie Walter; Kerstin Walter; Thomas Meissner; Martin Lindner; Regina Ensenauer; René Santer; Olaf A Bodamer; Matthias R Baumgartner; Michaela Brunner-Krainz; Daniela Karall; Claudia Haase; Ina Knerr; Thorsten Marquardt; Julia B Hennermann; Robert Steinfeld; Skadi Beblo; Hans-Georg Koch; Vassiliki Konstantopoulou; Sabine Scholl-Bürgi; Agnes van Teeffelen-Heithoff; Terttu Suormala; Wolfgang Sperl; Jan P Kraus; Andrea Superti-Furga; Karl Otfried Schwab; Jörn Oliver Sass Journal: Orphanet J Rare Dis Date: 2013-01-10 Impact factor: 4.123
Authors: Philip P Ostrowski; Andrew Barszczyk; Julia Forstenpointner; Wenhua Zheng; Zhong-Ping Feng Journal: PLoS One Date: 2016-05-26 Impact factor: 3.240