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Early recombinant human growth hormone treatment in glucocorticoid-treated children with juvenile idiopathic

Dominique Simon1, Anne-Marie Prieur, Pierre Quartier

  • 1Department of Pediatric Endocrinology, Robert Debré Teaching Hospital, 75019 Paris, France. dominique.simon@rdb.aphp.fr

The Journal of Clinical Endocrinology and Metabolism
|May 10, 2007
PubMed

Insights

Early recombinant human growth hormone (rhGH) therapy in children with juvenile idiopathic arthritis (JIA) preserved normal growth velocity and height. Carbohydrate metabolism requires close monitoring during rhGH treatment.

Area of Science:

  • Pediatric Endocrinology
  • Rheumatology
  • Growth Hormone Therapy

Background:

  • Long-term glucocorticoid therapy negatively impacts growth and body composition in children with juvenile idiopathic arthritis (JIA).
  • Previous studies indicated recombinant human growth hormone (rhGH) could halt these complications without causing catch-up growth.

Purpose of the Study:

  • To evaluate the impact of early rhGH initiation on growth and body composition in children with JIA.
  • To assess adverse effects associated with rhGH therapy in this pediatric population.

Main Methods:

  • A 3-year randomized controlled study involving 30 children with JIA undergoing glucocorticoid therapy.
  • Participants received daily subcutaneous injections of rhGH (n=15) or no rhGH therapy (n=15).
  • Evaluated outcomes included height standard deviation score (SDS) change, height velocity, body composition, and oral glucose tolerance.

Main Results:

  • rhGH treatment resulted in a significantly larger increase in height SDS compared to the control group (P=0.04).
  • Height velocity normalized within the first year of rhGH treatment and was maintained.
  • Patients receiving rhGH showed greater increases in lean mass (P=0.03), while fat mass and bone mineralization remained comparable between groups.

Conclusions:

  • Early initiation of rhGH in children with JIA effectively preserves normal growth velocity and height.
  • rhGH was generally well-tolerated, but close monitoring of carbohydrate metabolism is recommended.
Abstract

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