The therapeutic use of growth-hormone-releasing hormone

Abstract

As a significant number of children with growth hormone deficiency have been shown to be able to respond to GHRH with a rise in serum growth hormone (GH) levels, GHRH has been used to treat such children with varying success. GHRH has been given subcutaneously (SC) in GH deficient children to improve growth in dose frequencies of daily, twice daily, three-hourly overnight or three-hourly throughout the day. The dosages of GHRH used have been wide ranging, varying from 4 μg/kg/day to 50 μg/kg/day. Continuous infusion of GHRH has been shown to augment GH secretion in normal adults and GH deficient children without evidence of densensitization of the somatotrophs. Continuous SC infusion of GHRH has been shown to promote growth in short slowly growing children. Poor growth response to GHRH has been reported by some authors using daily SC injection while others reported significant growth acceleration in 42-87% of GH deficient children treated using different GHRH regimes. Although GH treatment in GH-deficient children results in more consistent growth acceleration, comparable growth response can be seen in some children treated with GHRH. The optimal mode of GHRH therapy remains to be determined, but it would appear that the growth response is dependent on the dose used and possibly on the frequency of administration. The development of a sustained release preparation of GHRH may prove to be an alternative to GH in the treatment of some Children with short stature.