%0 Generic %A S.R., Howard %A G.E., Butler %D 2013 %T Supplementary Material for: An Analysis of the Clinical and Cost Effectiveness of Growth Hormone Replacement Therapy before and during Puberty: Should We Increase the Dose? %U https://karger.figshare.com/articles/dataset/Supplementary_Material_for_An_Analysis_of_the_Clinical_and_Cost_Effectiveness_of_Growth_Hormone_Replacement_Therapy_before_and_during_Puberty_Should_We_Increase_the_Dose_/5124535 %R 10.6084/m9.figshare.5124535.v1 %2 https://karger.figshare.com/ndownloader/files/8710954 %K Growth hormone %K Puberty %K Height %K Growth %K Cost effectiveness %X Aim: To investigate the influence of growth hormone (GH) on linear growth before and during puberty in children with GH deficiency. Methods: We analysed the relationship between pubertal growth and GH dose in a large dataset of children (n = 236) with GH deficiency using multiple linear regression and multilevel modelling with repeated measures analysis. Additionally, we examined the cost benefit of increasing doses of GH during puberty. Results: Multilevel modelling revealed a highly significant role for GH dose in the pre-pubertal period (p < 0.001), but a non-significant effect on height gain after pubertal onset (p = 0.32). Important predictors of height gain after puberty onset included gender, age at puberty and number of injections of GH/week. Cost analysis showed that in an average child use of high dose GH, at an extra EUR 5,925 (GBP 4,753/USD 7,538)/year, would produce a height gain of 0.80 cm/year (above baseline growth) pre-pubertally, compared to only 0.20 cm/year post-puberty onset. Conclusions: The influence of GH dose on height gain after puberty onset is at best a modest one. Cost analysis shows use of high doses of GH post-puberty onset has significant cost implications without providing a worthwhile gain in adult height for children with GH deficiency. %I Karger Publishers