Growth Hormone Treatment for Growth Failure in Pediatric Patients with Crohn's Disease

• Published in: The Journal of pediatrics 2008-11, Vol.153 (5), p.651-658.e3
• Main Authors: Heyman, Melvin B., MD, MPH, Garnett, Elizabeth A., BA, Wojcicki, Janet, PhD, MPH, Gupta, Neera, MD, MAS, Davis, Cheryl, RD, CNSD, Cohen, Stanley A., MD, Gold, Benjamin D., MD, Kirschner, Barbara S., MD, Baldassano, Robert N., MD, Ferry, George D., MD, Winter, Harland S., MD, Kaplan, Selna, MD, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Body Composition; Body Height; Bone Density; Child; Child, Preschool; Crohn Disease - metabolism; Crohn Disease - therapy; Endocrine System; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Growth Disorders - drug therapy; Growth Hormone - therapeutic use; Humans; Male; Medical sciences; Other diseases. Semiology; Pediatrics; Recombinant Proteins - therapeutic use; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2008.04.064

Objective To investigate the effect of human growth hormone (GH) injections on growth velocity in growth-impaired children with Crohn's disease (CD). Study design Ten children and adolescents (mean age, 12.6 ± 4.5 years; 6 males) with CD and poor height growth were treated with open-label recombinant GH, 0.043 mg/kg/day administered via subcutaneous injection, for 1 year. Patients were retrospectively matched with untreated patients (3 comparisons per case) by race, age, sex, and baseline height. Primary endpoint was height velocity; secondary endpoints were disease activity, body composition, and bone density determined by dual-energy x-ray absorptiometry scan. Results Mean height velocity increased by 5.33 ± 3.40 (mean ± standard deviation) cm/year in the GH-treated patients during the year of GH treatment, compared with 0.96 ± 3.52 cm/year in the comparison group ( P = .03). Height z -score increased by 0.76 ± 0.38 in the treated group, compared with 0.16 ± 0.40 in the comparison group ( P < .01), and weight z -score increased by 0.81 ± 0.89 in the treated group, compared with 0.00 ± 0.57 in the comparison group ( P < .01). Bone density revealed an increase of 0.31 ± 0.33 in the lumbar spine z -score ( P = .03 vs baseline). Conclusions GH treatment increases height velocity and may enhance bone mineralization in children with CD. A randomized controlled trial in a large cohort of children is needed to evaluate the ultimate impact of GH treatment.