Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD

Joeri Vliegenthart; Jan M Wit; Boudewijn Bakker; Annemieke M Boot; Christiaan de Bruin; Martijn J J Finken; Josine C van der Heyden; Anita C S Hokken-Koelega; Hetty J van der Kamp; Edgar G van Mil; Theo C J Sas; Dina A Schott; Petra van Setten; Saartje Straetemans; Vera van Tellingen; Robbert N H Touwslager; A S Paul van Trotsenburg; Paul G Voorhoeve; Edmond H H M Rings; Erica L T van den Akker; Danielle C M van der Kaay

doi:10.1210/clinem/dgaf626

Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD

Joeri Vliegenthart
, Jan M Wit
, Boudewijn Bakker
, Annemieke M Boot
, Christiaan de Bruin
, Martijn J J Finken
, Josine C van der Heyden
, Anita C S Hokken-Koelega
, Hetty J van der Kamp
, Edgar G van Mil
, Theo C J Sas
, Dina A Schott
, Petra van Setten
, Saartje Straetemans
, Vera van Tellingen
, Robbert N H Touwslager
, A S Paul van Trotsenburg
, Paul G Voorhoeve
, Edmond H H M Rings
, Erica L T van den Akker

Danielle C M van der Kaay

Erasmus University Medical Centre, 3000, Netherlands
Leiden University Medical Centre
Division of Pediatric Endocrinology, Nijmegen, Netherlands
University Medical Centre Groningen
Dutch Growth Research Foundation
University Medical Center Utrecht
Jeroen Bosch Hospital
Zuyderland Hospital
Radboud University Medical Centre
Maastricht University Medical Centre
St. Antonius Hospital
AMsterdam University Medical Center
Canisius Wilhelmina Hospital

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

CONTEXT: In children with idiopathic isolated growth hormone deficiency (IIGHD), GH secretion often normalizes by near adult height (NAH). Whether rhGH treatment can be safely discontinued earlier remains unclear.

OBJECTIVE: To investigate if withdrawing rhGH treatment from mid-puberty onwards had no negative effect on attained NAH in adolescents who, after retesting, were no longer GH deficient.

DESIGN: Prospective multicenter patient preference study (2017-2024) with follow-up until NAH (SEENEZ GH Study).

SETTING: Pediatric endocrinology departments in multiple centers.

PATIENTS OR OTHER PARTICIPANTS: 127 adolescents (95 male, 75%) with childhood IIGHD (GH peak 1.7-10 µg/L) who tested GH sufficient (GH peak >6.7 µg/L) at mid-puberty. 44 continued rhGH (GHcont), 83 discontinued (GHstop). 99% of patients completed the study.

INTERVENTIONS: RhGH treatment continuation vs discontinuation from mid-puberty until NAH.

MAIN OUTCOME MEASURES: Primary: NAH-SDS minus target height (TH)-SDS. Secondary: NAH-SDS, total pubertal growth (TPG), and predicted vs attained height gain.

RESULTS: Mean (SD) NAH-SDS minus TH-SDS was -0.17 (0.60) in the GHcont and -0.18 (0.62) in the GHstop group (P=.96). Mean NAH-SDS was -0.91 (0.76) (GHcont) vs -0.78 (0.76) (GHstop) (P=.35). Mean (SD) TPG (from start of puberty) in males was 27.5 cm (7.0; GHcont) vs 25.9 cm (6.2; GHstop) (P =.25) and in females 20.5 cm (5.7; GHcont) vs 20.9 cm (7.6; GHstop) (P = .90). Predicted vs attained height gain based on the prediction model did not differ between groups.

CONCLUSIONS: In adolescents with transient IIGHD, rhGH treatment can be stopped at mid-puberty. These findings support reducing rhGH treatment duration, lowering patient burden and healthcare costs.

Original language	English
Journal	Journal of clinical endocrinology and metabolism
DOIs	https://doi.org/10.1210/clinem/dgaf626
Publication status	Published - 15 Nov 2025

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Vliegenthart, J., Wit, J. M., Bakker, B., Boot, A. M., de Bruin, C., Finken, M. J. J., van der Heyden, J. C., Hokken-Koelega, A. C. S., van der Kamp, H. J., van Mil, E. G., Sas, T. C. J., Schott, D. A., van Setten, P., Straetemans, S., van Tellingen, V., Touwslager, R. N. H., van Trotsenburg, A. S. P., Voorhoeve, P. G., Rings, E. H. H. M., ... van der Kaay, D. C. M. (2025). Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD. Journal of clinical endocrinology and metabolism. https://doi.org/10.1210/clinem/dgaf626

@article{5791fe226bff40fcaaf4ef186779ffe9,

title = "Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD",

abstract = "CONTEXT: In children with idiopathic isolated growth hormone deficiency (IIGHD), GH secretion often normalizes by near adult height (NAH). Whether rhGH treatment can be safely discontinued earlier remains unclear.OBJECTIVE: To investigate if withdrawing rhGH treatment from mid-puberty onwards had no negative effect on attained NAH in adolescents who, after retesting, were no longer GH deficient.DESIGN: Prospective multicenter patient preference study (2017-2024) with follow-up until NAH (SEENEZ GH Study).SETTING: Pediatric endocrinology departments in multiple centers.PATIENTS OR OTHER PARTICIPANTS: 127 adolescents (95 male, 75\%) with childhood IIGHD (GH peak 1.7-10 µg/L) who tested GH sufficient (GH peak >6.7 µg/L) at mid-puberty. 44 continued rhGH (GHcont), 83 discontinued (GHstop). 99\% of patients completed the study.INTERVENTIONS: RhGH treatment continuation vs discontinuation from mid-puberty until NAH.MAIN OUTCOME MEASURES: Primary: NAH-SDS minus target height (TH)-SDS. Secondary: NAH-SDS, total pubertal growth (TPG), and predicted vs attained height gain.RESULTS: Mean (SD) NAH-SDS minus TH-SDS was -0.17 (0.60) in the GHcont and -0.18 (0.62) in the GHstop group (P=.96). Mean NAH-SDS was -0.91 (0.76) (GHcont) vs -0.78 (0.76) (GHstop) (P=.35). Mean (SD) TPG (from start of puberty) in males was 27.5 cm (7.0; GHcont) vs 25.9 cm (6.2; GHstop) (P =.25) and in females 20.5 cm (5.7; GHcont) vs 20.9 cm (7.6; GHstop) (P = .90). Predicted vs attained height gain based on the prediction model did not differ between groups.CONCLUSIONS: In adolescents with transient IIGHD, rhGH treatment can be stopped at mid-puberty. These findings support reducing rhGH treatment duration, lowering patient burden and healthcare costs.",

author = "Joeri Vliegenthart and Wit, \{Jan M\} and Boudewijn Bakker and Boot, \{Annemieke M\} and \{de Bruin\}, Christiaan and Finken, \{Martijn J J\} and \{van der Heyden\}, \{Josine C\} and Hokken-Koelega, \{Anita C S\} and \{van der Kamp\}, \{Hetty J\} and \{van Mil\}, \{Edgar G\} and Sas, \{Theo C J\} and Schott, \{Dina A\} and \{van Setten\}, Petra and Saartje Straetemans and \{van Tellingen\}, Vera and Touwslager, \{Robbert N H\} and \{van Trotsenburg\}, \{A S Paul\} and Voorhoeve, \{Paul G\} and Rings, \{Edmond H H M\} and \{van den Akker\}, \{Erica L T\} and \{van der Kaay\}, \{Danielle C M\}",

note = "{\textcopyright} The Author(s) 2025. Published by Oxford University Press on behalf of the Endocrine Society.",

year = "2025",

month = nov,

day = "15",

doi = "10.1210/clinem/dgaf626",

language = "English",

journal = "Journal of clinical endocrinology and metabolism",

issn = "0021-972X",

publisher = "The Endocrine Society",

}

Vliegenthart, J, Wit, JM, Bakker, B, Boot, AM, de Bruin, C, Finken, MJJ, van der Heyden, JC, Hokken-Koelega, ACS, van der Kamp, HJ, van Mil, EG, Sas, TCJ, Schott, DA, van Setten, P, Straetemans, S, van Tellingen, V, Touwslager, RNH, van Trotsenburg, ASP, Voorhoeve, PG, Rings, EHHM, van den Akker, ELT & van der Kaay, DCM 2025, 'Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD', Journal of clinical endocrinology and metabolism. https://doi.org/10.1210/clinem/dgaf626

TY - JOUR

T1 - Growth Hormone Withdrawal in Mid-Puberty

T2 - No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD

AU - Vliegenthart, Joeri

AU - Wit, Jan M

AU - Bakker, Boudewijn

AU - Boot, Annemieke M

AU - de Bruin, Christiaan

AU - Finken, Martijn J J

AU - van der Heyden, Josine C

AU - Hokken-Koelega, Anita C S

AU - van der Kamp, Hetty J

AU - van Mil, Edgar G

AU - Sas, Theo C J

AU - Schott, Dina A

AU - van Setten, Petra

AU - Straetemans, Saartje

AU - van Tellingen, Vera

AU - Touwslager, Robbert N H

AU - van Trotsenburg, A S Paul

AU - Voorhoeve, Paul G

AU - Rings, Edmond H H M

AU - van den Akker, Erica L T

AU - van der Kaay, Danielle C M

PY - 2025/11/15

Y1 - 2025/11/15

N2 - CONTEXT: In children with idiopathic isolated growth hormone deficiency (IIGHD), GH secretion often normalizes by near adult height (NAH). Whether rhGH treatment can be safely discontinued earlier remains unclear.OBJECTIVE: To investigate if withdrawing rhGH treatment from mid-puberty onwards had no negative effect on attained NAH in adolescents who, after retesting, were no longer GH deficient.DESIGN: Prospective multicenter patient preference study (2017-2024) with follow-up until NAH (SEENEZ GH Study).SETTING: Pediatric endocrinology departments in multiple centers.PATIENTS OR OTHER PARTICIPANTS: 127 adolescents (95 male, 75%) with childhood IIGHD (GH peak 1.7-10 µg/L) who tested GH sufficient (GH peak >6.7 µg/L) at mid-puberty. 44 continued rhGH (GHcont), 83 discontinued (GHstop). 99% of patients completed the study.INTERVENTIONS: RhGH treatment continuation vs discontinuation from mid-puberty until NAH.MAIN OUTCOME MEASURES: Primary: NAH-SDS minus target height (TH)-SDS. Secondary: NAH-SDS, total pubertal growth (TPG), and predicted vs attained height gain.RESULTS: Mean (SD) NAH-SDS minus TH-SDS was -0.17 (0.60) in the GHcont and -0.18 (0.62) in the GHstop group (P=.96). Mean NAH-SDS was -0.91 (0.76) (GHcont) vs -0.78 (0.76) (GHstop) (P=.35). Mean (SD) TPG (from start of puberty) in males was 27.5 cm (7.0; GHcont) vs 25.9 cm (6.2; GHstop) (P =.25) and in females 20.5 cm (5.7; GHcont) vs 20.9 cm (7.6; GHstop) (P = .90). Predicted vs attained height gain based on the prediction model did not differ between groups.CONCLUSIONS: In adolescents with transient IIGHD, rhGH treatment can be stopped at mid-puberty. These findings support reducing rhGH treatment duration, lowering patient burden and healthcare costs.

AB - CONTEXT: In children with idiopathic isolated growth hormone deficiency (IIGHD), GH secretion often normalizes by near adult height (NAH). Whether rhGH treatment can be safely discontinued earlier remains unclear.OBJECTIVE: To investigate if withdrawing rhGH treatment from mid-puberty onwards had no negative effect on attained NAH in adolescents who, after retesting, were no longer GH deficient.DESIGN: Prospective multicenter patient preference study (2017-2024) with follow-up until NAH (SEENEZ GH Study).SETTING: Pediatric endocrinology departments in multiple centers.PATIENTS OR OTHER PARTICIPANTS: 127 adolescents (95 male, 75%) with childhood IIGHD (GH peak 1.7-10 µg/L) who tested GH sufficient (GH peak >6.7 µg/L) at mid-puberty. 44 continued rhGH (GHcont), 83 discontinued (GHstop). 99% of patients completed the study.INTERVENTIONS: RhGH treatment continuation vs discontinuation from mid-puberty until NAH.MAIN OUTCOME MEASURES: Primary: NAH-SDS minus target height (TH)-SDS. Secondary: NAH-SDS, total pubertal growth (TPG), and predicted vs attained height gain.RESULTS: Mean (SD) NAH-SDS minus TH-SDS was -0.17 (0.60) in the GHcont and -0.18 (0.62) in the GHstop group (P=.96). Mean NAH-SDS was -0.91 (0.76) (GHcont) vs -0.78 (0.76) (GHstop) (P=.35). Mean (SD) TPG (from start of puberty) in males was 27.5 cm (7.0; GHcont) vs 25.9 cm (6.2; GHstop) (P =.25) and in females 20.5 cm (5.7; GHcont) vs 20.9 cm (7.6; GHstop) (P = .90). Predicted vs attained height gain based on the prediction model did not differ between groups.CONCLUSIONS: In adolescents with transient IIGHD, rhGH treatment can be stopped at mid-puberty. These findings support reducing rhGH treatment duration, lowering patient burden and healthcare costs.

U2 - 10.1210/clinem/dgaf626

DO - 10.1210/clinem/dgaf626

M3 - Article

C2 - 41239863

SN - 0021-972X

JO - Journal of clinical endocrinology and metabolism

JF - Journal of clinical endocrinology and metabolism

ER -

Growth Hormone Withdrawal in Mid-Puberty: No Impact on Near Adult Height in Adolescents with Transient Idiopathic GHD

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