Growth hormone therapy with norditropin (somatropin) in growth hormone deficiency

Introduction: Growth hormone (GH) is indicated for therapy of growth hormone deficiency (GHD) in pediatric and adult patients. Introduction of recombinant human GH (rhGH) improved access to GH therapy. Norditropin [somatropin (rDNA origin) injection] is rhGH, used for the replacement of endogenous GH in children and adults with GHD. Areas covered: The article reviews rhGH therapy in GHD indication with focus on Norditropin Nordiflex delivery system. The goals of therapy in children are to promote linear growth and restore normal body composition. In adults with GHD rhGH restores normal body composition, improves cardiac function and normalizes cardiovascular risk factors such as low-density lipoprotein cholesterol and C-reactive protein. Expert opinion: Adverse reactions of rhGH therapy include intracranial hypertension, fluid retention, glucose intolerance, and children may experience worsening of scoliosis and slipped capital femoral epiphysis. Increased risk for intracranial tumors has also been reported in teenagers and young adults treated with radiation to the head as children for a first neoplasm. RhGH therapy requires daily injections, therefore improved ease of use of delivery devices may improve treatment outcomes. Several rhGH devices have been developed, and the Norditropin FlexPro prefilled pen is the newest delivery system which has small dose increments, does not require reconstitution and has flexible storage features.