The challenges of optimising the treatment of children diagnosed with idiopathic short stature

Physicians who treat children with idiopathic short stature (ISS) are challenged in deciding whether the intervention to improve final height is truly efficacious, given the heterogeneity of the diagnosis of ISS. There are numerous studies and reviews that have attempted to assess and demonstrate the benefit of various interventions, such as growth hormone therapy and aromatase inhibitors. Recently, Zhang et al. published a well-written meta-analysis entitled "Comparative effects of growth hormone, testosterone, and aromatase inhibitors on height gain in children and adolescents with idiopathic short statures: a network meta-analysis," attempting to stratify the benefit of several interventions. Our commentary seeks to highlight the importance of more research needed in this field and the complexities of treating children with ISS.