{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:15:27Z","timestamp":1789085727384,"version":"build-2803163510"},"reference-count":43,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2017-0489_s_999_w2aab3b7c40b1b6b1aab1c17b1Aa\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We investigated time trends in age, gender, growth hormone (GH) dose and height standard deviation score (SDS) in children with GH deficiency (GHD), born small for gestational age (SGA) or with Turner syndrome (TS) starting GH treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2017-0489_s_998_w2aab3b7c40b1b6b1aab1c17b2Aa\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data were obtained from children enrolled in the NordiNet\n                      <jats:sup>\u00ae<\/jats:sup>\n                      International Outcome Study (IOS) between 2006 and 2015 in the Czech Republic, France, Germany, Serbia and Montenegro (all indications), and Switzerland and the UK (GHD only). Trends were analyzed by linear regression. Patients were divided by age into early-, medium- or late-start groups in three different time periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2017-0489_s_997_w2aab3b7c40b1b6b1aab1c17b3Aa\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Approximately one-third of children starting treatment for GHD were girls, with no apparent increase in proportion over time. The mean baseline age for starting treatment decreased significantly (p&lt;0.001) for both GHD and SGA in the Czech Republic and Germany. In the other countries studied, over 40% of children started treatment for GHD and SGA late (girls &gt;10, boys &gt;11 years) between 2013 and 2015. The mean baseline GH doses were largely within recommended ranges for GHD and SGA, but below the lowest recommended starting dose for TS in almost every year since 2011 except in France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2017-0489_s_996_w2aab3b7c40b1b6b1aab1c17b4Aa\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Approximately one-third of children starting treatment for GHD were girls. Between 2013 and 2015, more than 40% of children started treatment for GHD and SGA late except in Germany and the Czech Republic. TS patients received below-recommended doses. These results highlight the need for earlier identification of short stature in children, particularly girls, and for dose optimization in TS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2017-0489","type":"journal-article","created":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T18:15:26Z","timestamp":1523643326000},"page":"521-532","source":"Crossref","is-referenced-by-count":17,"title":["Still too little, too late? Ten years of growth hormone therapy baseline data from the NordiNet\n                    <sup>\u00ae<\/sup>\n                    International Outcome Study"],"prefix":"10.1515","volume":"31","author":[{"given":"Michel","family":"Polak","sequence":"first","affiliation":[{"name":"Endocrinologie gyn\u00e9cologie diab\u00e9tologie p\u00e9diatriques, H\u00f4pital Universitaire Necker Enfants Malades, Assistance Publique-H\u00f4pitaux de Paris , Universit\u00e9 Paris Descartes, INSERM U1016, Institut IMAGINE, Centre de r\u00e9f\u00e9rence des Maladies Endocriniennes Rares de la Croissance et du D\u00e9veloppement , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Konrad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology and Diabetology and Children\u2019s Research Centre , University Children\u2019s Hospital , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte","family":"T\u00f8nnes Pedersen","sequence":"additional","affiliation":[{"name":"Epidemiology, Novo Nordisk A\/S , S\u00f8borg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gediminas","family":"Puras","sequence":"additional","affiliation":[{"name":"Global Medical Affairs, Novo Nordisk Health Care AG , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"\u0160najderov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, 2nd Faculty of Medicine , Charles University and University Hospital Motol , Prague , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2018,4,13]]},"reference":[{"key":"2021021322190074330_j_jpem-2017-0489_ref_001_w2aab3b7c40b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Lee PA, Germak J, Gut R, Khutoryansky N, Ross J. Identification of factors associated with good response to growth hormone therapy in children with short stature: results from the ANSWER Program(R). Int J Pediatr Endocrinol 2011;2011:6.","DOI":"10.1186\/1687-9856-2011-6"},{"key":"2021021322190074330_j_jpem-2017-0489_ref_002_w2aab3b7c40b1b6b1ab2b2b2Aa","doi-asserted-by":"crossref","unstructured":"Ranke MB, Lindberg A, Chatelain P, Wilton P, Cutfield W, et al. Derivation and validation of a mathematical model for predicting the response to exogenous recombinant human growth hormone (GH) in prepubertal children with idiopathic GH deficiency. KIGS International Board. Kabi Pharmacia International Growth Study. J Clin Endocrinol Metab 1999;84:1174\u201383.","DOI":"10.1210\/jcem.84.4.5634"},{"key":"2021021322190074330_j_jpem-2017-0489_ref_003_w2aab3b7c40b1b6b1ab2b2b3Aa","doi-asserted-by":"crossref","unstructured":"Westphal O, Lindberg A. 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