{
  "abstract": "Idiopathic short stature (ISS) is a height standard deviation score (HtSDS) below −2 SD for age and sex with no identifiable cause. Recombinant human growth hormone (rhGH) is an approved treatment for ISS; however, whether pubertal timing at treatment initiation affects final adult height (FAH) remains an important clinical question. This systematic review aimed to synthesise evidence on the effect of rhGH therapy on FAH in children with ISS, stratified by timing of treatment initiation, and to appraise the methodological quality of the included studies. A systematic search was performed in PubMed, Scopus, and Google Scholar, with predefined keywords and corresponding MeSH terms, including ISS, growth hormone, rhGH, adult height, and timing of therapy. Filters were applied for human studies, paediatric population (<18 years), and publication within the last 10 years. Two reviewers performed study selection and data extraction, and disagreements were resolved through discussion and consensus. In total, 14 studies comprising 5,878 participants across ISS-focused and mixed short-stature cohorts, published between 2016 and 2025 and representing six countries, were included: four randomised controlled trials (RCTs) and 10 observational, cohort, or registry studies. Prepubertal initiation was associated with the most consistent short-term growth responses, although the reported measures differed across studies. The largest registry analysis included 3,939 prepubertal children across diagnostic groups and showed no significant mean gain in near-adult HtSDS in the ISS subgroup. In pubertal boys, combined rhGH and an aromatase inhibitor was associated with an FAH SDS of −1.0 in one randomised trial, while late-pubertal retrospective cohorts reported FAH values of 170.9-173.5 cm in males. One RCT had a low risk of bias, while the remaining RCTs had some concerns, and three observational studies had a serious risk of bias. Earlier rhGH initiation, particularly during the prepubertal period, was associated with more consistent short-term growth responses; however, evidence that earlier initiation leads to superior FAH remains limited and heterogeneous. Further well-designed prospective studies with FAH as a primary endpoint and clearly defined pubertal timing are needed to clarify the effect of treatment timing.",
  "abstract_shown": true,
  "affiliations": [
    "Paediatric Department, Dubai Health Authority, Dubai, ARE",
    "Medical School, Dubai Health Authority, Dubai, ARE",
    "Paediatric Department, Mediclinic City Hospital, Dubai, ARE"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Israa W Khalid"
    },
    {
      "affs": [
        0
      ],
      "name": "Reem Abbas"
    },
    {
      "affs": [
        1
      ],
      "name": "Nabaa W Khalid"
    },
    {
      "affs": [
        2
      ],
      "name": "Samar S Hassan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6jnazvv860w9e.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117198",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13720937/?tool=EBI",
  "id": "6jnazvv860w9e",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13720937",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Endocrinology/Diabetes/Metabolism"
    ],
    [
      "heading",
      "Epidemiology/Public Health"
    ],
    [
      "heading",
      "Pediatrics"
    ],
    [
      "openalex",
      "2712|Growth Hormone and Insulin-like Growth Factors"
    ]
  ],
  "openalex": "W7214926988",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13720937/pdf/?tool=EBI",
  "pmcid": "PMC13720937",
  "pmid": "42964989",
  "published": "2026-09-30",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/6jnazvv860w9e.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:36Z",
      "native_id": "PMC:PMC13720937",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13720937"
    },
    {
      "first_seen": "2026-11-03T12:21:43Z",
      "native_id": "PMC13720937",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117198"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Pediatrics",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Timing of Growth Hormone Therapy Initiation and Final Adult Height in Idiopathic Short Stature: A Systematic Review",
  "title_text": "Timing of Growth Hormone Therapy Initiation and Final Adult Height in Idiopathic Short Stature: A Systematic Review",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:43Z",
  "url": "https://research.draconitic.com/paper/6jnazvv860w9e",
  "venue": "Cureus",
  "versions": []
}