The effects of recombinant human growth hormone on linear growth in children with Crohn's disease and short stature

J Pediatr Endocrinol Metab. 2007 Dec;20(12):1315-24. doi: 10.1515/jpem.2007.20.12.1315.

Abstract

Background/aims: The efficacy of recombinant human growth hormone (rhGH) in treating the growth failure associated with Crohn's disease (CD) is unclear.

Methods: Retrospective data analysis at 12 months before (T-12), 6 months before (T-6), at baseline (T+0), 6 months after (T+6) and 12 months after (T+12) rhGH treatment in seven patients with CD (five males).

Results: Median chronological age (CA) and median difference between CA and bone age was 15.9 yr (range, 13.0 to 17.9) and 1.7 yr (-0.7 to 3.3), respectively. Median dose of rhGH at T+0 was 0.23 mg/wk (0.15 to 0.31). Pubertal status remained unchanged in 6/7 patients. Median albumin and C-reactive protein (CRP) were similar at T+0 and T+6. Median height SDS at T+0, T+6 and T+12 was -2.2 (-4.0 to -1.5), -1.9 (-4.1 to -0.8), -1.9 (-4.1 to -0.7), respectively (NS). Median height velocity (HV) SDS at T+0 and T+6 was -2.5 (-4.8 to 1.4) and -0.9 (-5.3 to 3.4), respectively (NS). There was a positive correlation between percentage change in HV SDS at T+6 and dose of rhGH at T+0 (r = 0.8, p = 0.03).

Conclusion: Introduction of rhGH therapy was associated with a cessation in the deterioration in linear growth. However, an improvement in height SDS was not observed over the period of the study. Future studies should explore the efficacy of a higher dose of rhGH in CD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Age Determination by Skeleton / methods
  • Age Factors
  • Antibodies, Monoclonal / therapeutic use
  • Body Height / drug effects*
  • C-Reactive Protein / analysis
  • Child
  • Crohn Disease / drug therapy*
  • Crohn Disease / physiopathology
  • Dose-Response Relationship, Drug
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Growth Disorders / blood
  • Growth Disorders / drug therapy*
  • Growth Disorders / physiopathology
  • Human Growth Hormone / administration & dosage
  • Human Growth Hormone / genetics
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Infliximab
  • Injections, Subcutaneous
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / therapeutic use
  • Physical Examination / methods
  • Puberty / physiology
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use*
  • Retrospective Studies
  • Serum Albumin / analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Glucocorticoids
  • Recombinant Proteins
  • Serum Albumin
  • Human Growth Hormone
  • C-Reactive Protein
  • Infliximab
  • Methotrexate