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One year treatment with clonidine in children with constitutional growth delay
B Moreno Esteban1, S Monereo Mejías, P Rodríguez Poyo-Guerrero
1Servicio Endocrinología, Hospital General, Madrid, Spain.
Insights
Clonidine treatment significantly increased growth velocity in prepubertal children with short stature. This alpha 2 agonist shows potential for treating constitutional growth delay in some children.
Area of Science:
- Pediatric Endocrinology
- Pharmacology
Background:
- Short stature and delayed bone age are common concerns in pediatric endocrinology.
- Assessing growth velocity is crucial for diagnosing and managing growth disorders.
Purpose of the Study:
- To evaluate the therapeutic potential of clonidine in prepubertal children with short stature and delayed bone age.
- To compare the efficacy of clonidine versus vitamin treatment on growth velocity.
Main Methods:
- A study involving 112 prepubertal children (51 boys, 39 girls) with short stature and delayed bone age.
- Oral administration of clonidine (0.075 mg/m2) or vitamin treatment for at least one year.
- Comparison of growth velocity changes between the clonidine and control groups.
Main Results:
- Clonidine treatment increased growth velocity to 6.6 cm/yr in boys and 6.5 cm/yr in girls, compared to 4.9 cm/yr (boys) and 5 cm/yr (girls) in the vitamin group.
- Bone age remained delayed by 1.5 years in both groups.
- A significant growth velocity increase (>2 cm/yr) was observed in 65% of clonidine-treated patients.
Conclusions:
- Clonidine may be a useful pharmacological agent for treating constitutional growth delay in select pediatric patients.
- The drug demonstrated a notable increase in growth velocity in a majority of treated children.
- Further research may explore optimal patient selection for clonidine therapy.
Abstract:
The therapeutic potential of clonidine was evaluated in 112 prepubertal children with short stature, delayed bone age and a growth velocity of 4.1 +/- 0.4 cm/yr in boys and 4.2 +/- 0.5 cm/yr in girls. The alpha 2 agonist was orally administered at 0.075 mg/m2 to 51 boys and 39 girls over a period of at least one year, and the effect compared to a vitamin treatment given to 10 age matched boys and 12 age matched females showing similar growth velocities. After one year of treatment growth velocity was increased to 6.6 +/- 1.2 cm/yr in boys and 6.50 +/- 1.0 cm/yr in girls treated with the drug, whereas in those given vitamins only 4.9 +/- 0.7 cm/yr in boys and 5 +/- 0.6 cm/yr in girls was recorded. Bone age remained 1.5 +/- 0.3 yr behind chronological age in both vitamin and clonidine treated groups. If only the 65% of patients that show a growth velocity increment of more than 2 cm/yr are considered the growth velocity reaches 7.20 +/- 0.82 cm/yr in boys and 6.68 +/- 0.75 cm/yr in girls, indicating that clonidine may be a useful pharmacological agent in the treatment of some patients with constitutional growth delay. The remaining 35% patients do not show any significant increase in growth velocity.