Somatropin (Growth hormone) (Various – Omnitrope®, Genotropin®, Norditropin®) – Children with growth failure with growth hormone deficiency, Turner syndrome, Prader-Willi syndrome and chronic renal insufficiency – as per NICE TA 188 and East of England PAC policy

NICE recommendations, summary of meeting discussions, links to additional supporting docs etc.

See also the the Red section for use in adults.

NICE guidance May 2002 – recommended for children with Turner syndrome (TS), pre-pubertal children with (CRI) providing nutritional status has been optimised, metabolic abnormalities have been optimised and steroid therapy has been reduced to a minimum, and for Prader-Willi syndrome. Treatment should be initiated and monitored by a specialist paediatrician. Continued treatment can be maintained under a shared-care protocol with a GP.

Various shared care protocols available from specialist centres. Agree with supervising consultant.

Local agreement of service provision states that for the present, prescribing responsibility will remain with Hospital specialists – Red.

July 2010: The TAG noted revised guidance from NICE – TA 188 (May 2010):

This guidance replaced TA 42 (May 2002).

Human growth hormone (somatropin) is still recommended for the treatment of growth failure in children with growth hormone deficiency, Turner syndrome, Prader-Willi syndrome and chronic renal insufficiency. The guidance has been extended to include growth failure associated with :

* those born small for gestational age with subsequent growth failure at 4 years of age or later

* those with short stature homeobox-containing gene (SHOX) deficiency.

January 2011: The TAG noted guidance for GPs on the use of somatropin in the management of growth disorders developed by Dr Nandu Thalannge (NNUH). Available via TAG information on  the Knowledge Management website.

March 2015:  The TAG noted the East Of England Priorities Advisory Committee’s (PAC) Guidance Statement (March 2014)

regarding recommendations for rationalisation of human growth hormone (somatroptin) products and was adivsed of local paeitrician’s intention to feedback on its content to the PAC.

March 2015: The Norfolk & Waveney CCGs’ D&TCG noted the PAC Guidance Statement from 2014 and was advised of the local paediatrician’s intention to feedback on its content. The D&TCG was also advised that subsequent tendering arrangements regarding purchasing of growth hormone products have necessitated a further review of the PAC Guidance Statement.

Local use of somatropin is currently being monitored on behalf of commissioners.

March 2017:  The TAG considered the PAC recommendations for growth hormone devices in children with respect to local HGH guidance for GPs, last approved January 2012, and recommended that the newer PAC document be adopted to replace the previous guidance from the TAG.

March 2017:  The NHS Norfolk & Waveney CCGs’ D&TCG noted and supported the TAG recommendation.