Somatrogon versus somatropin in children with growth hormone deficiency: a real-world matched-cohort study

Purpose: Somatrogon is a once-weekly growth hormone (GH) analog approved for GH deficiency (GHD), but real-world head-to-head data are limited. Using a matched-cohort design with a protocol-defined IGF-1 sampling time, we compared first-year growth outcomes and safety of somatrogon and daily somatropin in children with GHD. Methods: We conducted a retrospective matched-cohort study in 30 children with GHD (15 per group) at a single center. Groups were matched by age (±1 year), sex, and pubertal stage. Annual height velocity (AHV), height standard deviation score (SDS) gain, insulin-like growth factor 1 (IGF-1) SDS, insulin-like growth factor binding protein 3 (IGFBP-3), bone age advancement, and metabolic parameters were assessed at 12 months. Results: AHV was similar in both groups (8.96±1.67 vs 8.84±1.57 cm/year; p=0.841). Height SDS gain did not differ (0.60±0.36 vs 0.53±0.33; p=0.569). IGF-1 SDS was numerically higher in the somatrogon group (+0.59 vs -0.14; p=0.132) but remained within safe limits in all patients. Bone age advancement, glucose, and insulin levels were similar between groups. No adverse events or injection-site reactions were documented during follow-up. Conclusion: In this matched cohort, no significant differences in growth or safety outcomes were observed between somatrogon and somatropin at one year. Somatrogon appears to be a reasonable alternative to daily GH therapy in children with GHD.