New directions in growth hormone treatment in children.

This paper reviews clinical-trial evidence on the use of long-acting growth hormone (LAGH) preparations in children. Three LAGH products have been approved in Europe and the United States for paediatric growth hormone deficiency (GHD): lonapegsomatropin, somapacitan, and somatrogon. Ongoing clinical programmes are evaluating these agents in other causes of short stature that may warrant growth hormone therapy, including Turner syndrome, Noonan syndrome, children born small for gestational age (SGA)/with intrauterine growth restriction (IUGR), idiopathic short stature (ISS), SHOX gene variants, and achondroplasia; the present article summarises the design assumptions of these trials. In addition, the paper discusses the potential role of LAGH in patients with persistent GHD after completion of linear growth, i.e. those transitioning into adulthood and requiring ongoing replacement therapy. Finally, preliminary data are presented on the use of an oral growth hormone secretagogue, ibutamoren, in children with partial GH deficiency.