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POLICY AND PRACTICE REVIEWS article

Front. Endocrinol.
Sec. Pediatric Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1459998

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

Provisionally accepted
Willem Staels Willem Staels 1,2*Jean De Schepper Jean De Schepper 1Marianne Becker Marianne Becker 3Philippe Lysy Philippe Lysy 4Daniel Klink Daniel Klink 5Karl Logghe Karl Logghe 6Marieke Den Brinker Marieke Den Brinker 7Anne Rochtus Anne Rochtus 8Bruno Lapauw Bruno Lapauw 9Martine Cools Martine Cools 10Orsalia Alexopoulou Orsalia Alexopoulou 11Marie A. Bex Marie A. Bex 12Bernard Corvilain Bernard Corvilain 13Laurent Crenier Laurent Crenier 13Christophe De Block Christophe De Block 14Julian Donckier Julian Donckier 15Robert Hilbrands Robert Hilbrands 16Patrick Pétrossians Patrick Pétrossians 17Michel Ponchon Michel Ponchon 18Guy T'sjoen Guy T'sjoen 9Annick Van Den Bruel Annick Van Den Bruel 19Sara Vandewalle Sara Vandewalle 19Brigitte Velkeniers Brigitte Velkeniers 16
  • 1 Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Pediatrics, Division of Pediatric Endocrinology, Brussels, Belgium
  • 2 Genetics, Reproduction and Development (GRAD), Vrije Universiteit Brussel (VUB), Brussels, Belgium., Brussels, Belgium
  • 3 Division of Pediatric Endocrinology, Department of Pediatrics, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
  • 4 Division of Pediatric Endocrinology and Diabetes, Cliniques Universitaires Saint Luc, Brussels, Belgium
  • 5 Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children’s Hospital Antwerp, Antwerp, Belgium
  • 6 Department of Pediatrics, AZ Delta, Roeselare, Belgium
  • 7 Division of Pediatric Endocrinology, Department of Pediatrics, Universitair Ziekenhuis Antwerpen, Antwerp, Belgium
  • 8 Division of Pediatric Endocrinology, Department of Pediatrics, Universitair Ziekenhuis Leuven, Leuven, Belgium
  • 9 Department of Endocrinology , Universitair Ziekenhuis Gent, Ghent, Belgium
  • 10 Department of Paediatrics, Division of Paediatric Endocrinology, Ghent University Hospital and Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
  • 11 Department of Endocrinology, Cliniques Universitaires Saint Luc, Brussels, Belgium
  • 12 Department of Endocrinology, UZ Leuven (Universitaire Ziekenhuizen Leuven), Leuven, Belgium
  • 13 Department of Endocrinology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
  • 14 Department of Endocrinology and Diabetes, Universitair Ziekenhuis Antwerpen (UZA), Universiteit Antwerpen (UA), Antwerp, Belgium
  • 15 Department of Endocrinology, Université Catholique de Louvain CHU UCL Namur (Site Godinne), Yvoir, Belgium
  • 16 Department of Diabetes and Endocrinology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
  • 17 Department of Clinical Endocrinology, CHU de Liège, Liège, Belgium
  • 18 Department of Endocrinology, Cliniques Saint Jean, Brussels, Belgium
  • 19 Department of Endocrinology, AZ Sint Jan Brugge AV, Brugge, Belgium

The final, formatted version of the article will be published soon.

    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.

    Keywords: Growth hormone deficiency (GHD), Growth hormone therapy, Transition, Growth Hormone Stimulation Tests, policy for transition care

    Received: 05 Jul 2024; Accepted: 09 Sep 2024.

    Copyright: © 2024 Staels, De Schepper, Becker, Lysy, Klink, Logghe, Den Brinker, Rochtus, Lapauw, Cools, Alexopoulou, Bex, Corvilain, Crenier, De Block, Donckier, Hilbrands, Pétrossians, Ponchon, T'sjoen, Van Den Bruel, Vandewalle and Velkeniers. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Willem Staels, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Pediatrics, Division of Pediatric Endocrinology, Brussels, Belgium

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.