Wang AC, Hagen CP, Nedaeifard L, et al. - Researchers conducted this retrospective, real-world evidence, observational study to evaluate the impact of long-term growth hormone (GH) treatment in girls with Turner syndrome (TS) following GH dosing by insulin-like growth factor-1 (IGF-1) titration. Data were collected in a single tertiary center from 1991 to 2018. A cohort of 63 girls with TS treated with GH with IGF-1 titration of 6.7 years of median duration (interquartile range [IQR]: 3.4-9.7 years). Longitudinal measurements of height, IGF-1, and adult height (AH) following GH treatment were assessed and contrasted between the different karyotypes (45,X, 45,X/46,XX, or miscellaneous). Only 6% of girls with TS had supranormal IGF-1 levels using GH dose titration according to IGF-1. The median dose was 33 µg/kg/day (IQR: 28-39 µg/kg/day) with no karyotype difference between groups. The real-world evidence study indicated that titration of GH dose to keep levels of IGF-1 within the normal range resulted in a lower AH gain than in studies where a fixed dose was used.