Somatropin for Short Stature

For children with short stature who were born small for gestational age, 1 guideline suggests increasing human growth hormone dose when treatment response is unsatisfactory, while aiming for normal insulin-like growth factor 1 levels. For children with idiopathic short stature, 1 guideline recommends against the routine use of growth hormone. It suggests initiating growth hormone therapy on a case-by-case basis, with a starting dose ranging from 0.24 mg/kg/week to 0.47 mg/kg/week, as well as conducting an assessment 12 months after initiation to optimize dosage. The development of recommendations from guidelines included in this report was challenged by limited relevant evidence, as well as heterogeneity of growth hormone dose and frequency and treatment response found in available literature. Future guidelines should also consider patient perspectives, resource implications, and the facilitators of and barriers to therapy within the context of health care systems in Canada.