Global situation of growth hormone treatment in growth hormone- deficient children

Diagnostic criteria and treatment modalities were investigated through questionnaires from eleven countries and compared with those in Japan. All countries but Australia, where the patients can be treated with GH judged by only auxological data, use the combination of auxological data and peak GH value in provocation tests. GH value is still gold standard, but the cut off value differs among countries. Apart from the differences in cut off value, since it is well-known that GH concentrations vary according to the assay methods and measurement kits, standardization of the measurement kits is mandatory. GH dose ranges between 0.5 and 0.7 IU/kg/week in most countries. The lowest dose (fixed dose of 0.5 IU/kg/week) is used in Japan and the heightest dose (1.05 IU/kg/week) is used in the USA. The costs for GH treatment are most expensive in Japan.