Study wrapper · #259
Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency.
Editor's note
This is a narrative review of sermorelin's use as both a diagnostic agent and a paediatric therapy for idiopathic growth hormone deficiency (GHD) - a context that sits behind sermorelin's actual FDA approval history, and is quite distinct from the adult off-label body-composition and anti-ageing uses discussed in community settings. The review reports that a single intravenous 1 microg/kg dose provokes a relatively specific growth-hormone response useful for diagnosis, and that once-daily subcutaneous 30 microg/kg at bedtime was associated with increased height velocity in some prepubertal children, sustained over 12 months. Two caveats deserve weight: the height-velocity gains reported here were smaller than those seen with recombinant somatropin, and a normal response cannot rule out hypothalamic-origin GHD. As a review of an established, if now commercially withdrawn, indication, this is among the stronger evidence in the sermorelin file - but it speaks to children with a diagnosed deficiency, not to healthy adults. Reported adverse events were transient facial flushing and injection-site pain.
Plain-language abstract
Sermorelin is a synthetic 29-amino-acid fragment of the natural hormone (GHRH) that signals the pituitary gland to release growth hormone. This review summarised how sermorelin had been used in two ways in children. First, as a diagnostic test: a single injection into a vein prompts a growth-hormone response that helps identify children who may have a growth hormone deficiency, with fewer false-positive results than some other tests. The authors note a normal response does not fully rule out deficiency originating in the hypothalamus. Second, as a daily treatment: an injection under the skin at bedtime (30 micrograms per kilogram) was associated with faster growth in some children with idiopathic growth hormone deficiency who were short and growing slowly, with the effect lasting through 12 months and, in a few children, up to 36 months. However, the growth gains were smaller than those seen with standard recombinant growth hormone (somatropin), and the long-term effect on final adult height was not determined. The injections were generally well tolerated; the most common reported side effects were brief facial flushing and pain at the injection site.