Pediatric Rheumatology Online Journal → August 2003 → Miscellaneous Clinical Studies and Case Reports → Abstract #193

GROWTH HORMONE TREATMENT IN CHILDREN WITH RHEUMATIC DISEASES

L. W. A. Van Suijlekom-Smit,¹ F. K. Grote,^1,2 D. Mul,¹ R. Ten Cate,^1,2 W. Oostdijk,² W. Van Luijk,³ W. C. J. Hop,⁴ S. M. P. F. De Muinck Keizer-Schrama.¹

¹Pediatrics, Erasmus MC University Medical Center Sophia Children's Hospital, Rotterdam, Netherlands; ²Pediatrics, Leiden University Medical Center, Leiden, Netherlands; ³Pediatrics, University Hospital Groningen, Groningen, Netherlands; ⁴Epidemiology and Biostatistics, Erasmus MC University Medical Center, Rotterdam

Introduction: Children with severe Rheumatic Diseases (RD) frequently need corticosteroids (CS). Growth retardation and osteopenia may develop. A beneficial effect of Human Growth Hormone (hGH) is reported, mostly in uncontroled studies.
Objective: To study the effect of hGH on growth and bone mineral density (BMD).
Methods: A randomised controlled trial on 17 RD-patients with growth retardation and/or decreased BMD.
10 children received hGH 4 U/m2/day during 2 years, 7 children functioned as controle group.
Parameters: growth as Height SDS (HSDS), BMD by Dual Energy X-ray Absorptiometry (DEXA, LUNAR), disease activity, accumulative CD dose, quality of life. BMAD =apparent BMD to account for difference in bone size.
Results: In mean (SEM). At the start of the study groups were compatible: age: 8.3 (0.54) versus 9.0 (0.74); HSDS:-1.4 (0.33) versus -1.6 (0.32); BMD SDS for lumbar spine: -1.3 (0.32) versus -1.9 (0.32); BMD SDS for total body: -0.8 (0.25) versus -1.5 (0.38); BMAD SDS: -0.7 (0.33) versus -1.4 (0.49). The table shows the mean increases per year during the first 2 years of study + SEM. ([lowast>=significant).
Conclusions: After 2 years hGH the HSDS increased significantly; the effect on bone density was not significant, a longer treatment might be necessary to evaluate this effect.
Tabel
hGH Controle Treatment versus controle
Change in Height SDS 0.21 + 0.07 (p=0.014[lowast>) -0.12 + 0.09 (p=0.201) p=0.014[lowast>
Change in BMD SDS for total body -0.08 + 0.13(p=0.515) -0.15 + 0.15(p=0.322) p=0.738
Change in BMD SDS for lumbar spine 0.26 +0.11 (p =0.032[lowast>) 0.17 +0.14 (p=0.231) p =0.612
Change in BMAD SDS for lumbar spine 0.07 +0.14 (p=0.644) -0.17+0.18(p=0.344) p =0.308