Publications by authors named "Lawrence A Silverman"

Article Synopsis
  • Weekly injections for treating growth deficiency in children are just as effective as daily injections, showing similar growth rates.
  • The safety of weekly injections is comparable to daily injections, indicating no significant risk differences.
  • It's important to note that treatment decisions should consider all evidence, not just one study, and approval for the drug may vary by country.
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A thorough history and physical examination including Tanner staging and growth assessments can guide differential diagnosis and aid in the evaluation of precocious puberty. Basal luteinizing hormone levels measured using a highly sensitive assay can be helpful in diagnosing central precocious puberty (CPP). Brain MRI is indicated with males diagnosed with CPP and females under the age of 6 with CPP.

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Introduction: Studies of gonadotropin-releasing hormone analogues (intramuscular [IM] leuprolide acetate [LA] and triptorelin) for treatment monitoring of central precocious puberty (CPP) demonstrate this approach is effective for confirming pubertal hormone suppression. Herein, we provide new data using subcutaneous LA (SC LA), suggesting similar efficacy for treatment monitoring.

Methods: PubMed, Embase, and CINAHL were searched for studies of GnRHa used to monitor treatment of CPP.

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Gonadotrophin dependent sexual precocity, commonly referred to as central precocious puberty (CPP), results from a premature reactivation of the hypothalamic-pituitary-gonadal (HPG) axis before the normal age of pubertal onset. CPP is historically described as girls who enter puberty before the age of eight, and boys before the age of nine. Females are more likely to be diagnosed with idiopathic CPP; males diagnosed with CPP have a greater likelihood of a defined etiology.

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Gonadotropin-releasing hormone agonists (GnRHa's) are the standard treatment for children with central precocious puberty (CPP). We aim to present data on available GnRHa options with an easy-to-review table and discuss factors that influence treatment selection. Five GnRHa's are currently FDA-approved and prescribed in the US and published data suggest similar safety and efficacy profiles over the first year of treatment.

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Article Synopsis
  • The study aimed to examine how well children with pediatric growth hormone deficiency (pGHD) adhered to treatment with somatropin over three years and the reasons for any discontinuation.
  • It involved children aged 3 to 16 covered by Medicaid, analyzing data based on prescription fills from July 2014 to December 2018, defining adherence as a medication possession ratio and discontinuation as gaps between prescriptions.
  • Results indicated that over time, adherence declined (from 40.9% to 54.4% suboptimal adherence), with certain sociodemographic factors, such as age and race, influencing adherence and discontinuation rates, highlighting the need for targeted interventions.
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Article Synopsis
  • Somatrogon is a long-acting growth hormone being tested for once-weekly use in treating children with growth hormone deficiency (GHD).
  • A study with 228 prepubertal children compared the effectiveness and safety of somatrogon with daily somatropin over 12 months, finding somatrogon provided slightly better height velocity growth.
  • Both treatments showed similar levels of safety and tolerability, indicating that once-weekly somatrogon is effectively comparable to daily somatropin for treating GHD.
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Objectives: Gonadotropin-releasing hormone analogs are the treatment of choice for central precocious puberty (CPP). This study characterizes patients treated with histrelin implant or leuprolide injection.

Methods: A US claims database was used to identify patients aged ≤20 years with ≥1 histrelin or leuprolide claim (index treatment) between April 2010 and November 2017 and continuous enrollment ≥3 months before and ≥12 months after the index treatment date.

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Article Synopsis
  • A unique male with a dicentric Y chromosome was studied to compare his physical and cognitive characteristics to those of males with the 47,XYY chromosome arrangement, known to be linked to certain behavioral and autism risk factors.
  • This male showed tall stature and typical cognitive function with no signs of autism, despite having increased expression of some Y chromosome genes and not expressing the gene NLGN4Y which is thought to affect autism risk.
  • The findings suggest that the lack of NLGN4Y expression could be important in preventing autism symptoms, indicating a need for more research on NLGN4Y's role in autism risk in males with XYY abnormalities.
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Background: Iodine deficiency is the most common cause of acquired hypothyroidism worldwide. Although uncommon in the Western world, the incidence of iodine deficiency may be rising due to the increased use of restrictive diets.

Case Presentation: We present a 23-month-old boy diagnosed with iodine deficiency hypothyroidism, induced by a vegan diet.

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Background/aims: Growth hormone (GH) treatment regimens for children with non-GH-deficient, idiopathic short stature (ISS) have not been optimized. To compare the efficacy, efficiency, and safety of an individualized, target-driven GH regimen with standard weight-based dosing after 4 years of treatment.

Methods: This is a 4-year, open-label, multicenter, randomized trial comparing individualized, formula-based dosing of Genotropin® versus a widely used ISS dose of Genotropin®.

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Context And Objective: The histrelin implant has proven to be an effective method of delivering GnRH analog (GnRHa) therapy to children with central precocious puberty (CPP), yet there are limited data available regarding hormonal suppression and auxological changes during an extended course of therapy.

Design: This was a phase 3, prospective, open-label study.

Setting And Participants: Thirty-six children with CPP who participated in a phase 3, open-label study and required further GnRHa therapy were eligible to continue treatment receiving a new implant upon removal of the prior 12-month histrelin implant during a long-term extension phase.

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Although gonadotropin-releasing hormone agonists (GnRHa) have been the standard of care of central precocious puberty (CPP) management for many years, there are still questions about the long-term consequences of treatment. With increased utilization of GnRHa treatment, it is now possible to assess posttreatment outcomes in the immediate posttreatment period and into adulthood. This literature review reports on the long-term effects of GnRHa therapy in girls with CPP after therapy has been discontinued.

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Background: Gonadotropin-releasing hormone agonist (GnRHa)-stimulated luteinizing hormone (LH) is the standard hormonal assessment for both diagnosis and therapeutic monitoring of children with central precocious puberty (CPP). Use of unstimulated (random) LH levels may be helpful in diagnosis and has gained popularity in monitoring GnRHa therapy despite lack of validation against stimulated values. The objective of this investigation was to assess the suitability of random LH for monitoring pubertal suppression during GnRHa treatment.

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Background: Improved ease of use of drug-delivery devices may enhance compliance. Development of an easier-to-use device for administration of recombinant human growth hormone (rhGH) may thus be beneficial for patients and their caregivers.

Objective: This study compared ease of use and preference for a new disposable rhGH injection pen relative to previous experience with the currently available reusable pen in standard practice.

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