Frontiers in Endocrinology (Sep 2024)

Policy for transitioning childhood-onset growth hormone deficiency from pediatric to adult endocrine care in Belgium

  • Willem Staels,
  • Willem Staels,
  • Jean De Schepper,
  • Marianne Becker,
  • Philippe Lysy,
  • Daniel Klink,
  • Karl Logghe,
  • Marieken den Brinker,
  • Anne Rochtus,
  • Bruno Lapauw,
  • Martine Cools,
  • Martine Cools,
  • Orsalia Alexopoulou,
  • Marie Bex,
  • Bernard Corvilain,
  • Laurent Crenier,
  • Christophe De Block,
  • Julian Donckier,
  • Robert Hilbrands,
  • Michel Ponchon,
  • Guy T'Sjoen,
  • Annick Van Den Bruel,
  • Sara Vandewalle,
  • Brigitte Velkeniers

DOI
https://doi.org/10.3389/fendo.2024.1459998
Journal volume & issue
Vol. 15

Abstract

Read online

Growth hormone (GH) deficiency (GHD) in children and adolescents can vary in severity and origin, with GH replacement therapy proving effective in achieving genetic target height. Optimal outcomes are seen in those treated early and with higher doses. As patients approach adult height, priorities shift towards optimizing metabolic effects, maintaining body composition, and enhancing bone mass and muscle strength. Transitioning from pediatric to adult care presents challenges, including accurately identifying candidates for continued GH therapy, reevaluating persistent GHD, and preventing treatment discontinuation. Assessing readiness for transition and self-management skills is crucial. This Policy and Practice Review provides a comprehensive overview of current policies, regulations, and guidelines pertinent to managing GHD transition in Belgium. We integrate perspectives from national academic and nonacademic clinical stakeholders in pediatric and adult endocrine care to provide an updated policy framework. This framework underscores the importance of sustained GH therapy during transition, particularly for individuals with persistent GHD, with the goal of optimizing practices and improving outcomes during this critical period.

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