Authors' conclusions: growth hormone therapy in children with idiopathic short stature seems to be effective in partially reducing the deficit in height as adults, increasing adult height by about 4 cm, although the magnitude of effectiveness is on average less than that achieved in other conditions for which growth hormone is licensed. The individual response to therapy is highly variable, and additional studies are needed to identify the responders.
Reviewers' commentary: children with idiopathic short stature constitute a fixed proportion of the population, with about 2-3% of children 2 SD below the mean and 0.1% 3 SD below the mean. This high quality systematic review concludes that the administration of growth hormone in these children increases adult height by about 4 cm. Adding the cost of the therapy, the potential adverse effects (metabolic diseases and increased risk of malignancy into adult life) and difficulties for adequate adherence to the treatment, growth hormone therapy in short otherwise normal children, should be implemented with caution.